Daily gaseous air pollution and pediatric conjunctivitis: A case-crossover study across ten cities in China's southeastern coastal region

Zengliang Ruan ¹, Amanda Högdén ², Tao Zhang ³

¹Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, Nanjing, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
²Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
³Guangzhou Yuexiu District Children's Hospital, Guangzhou, China.
⁴Department of Ophthalmology, the First People's Hospital of Xuzhou & the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China.
⁵Department of Ophthalmology, the Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
⁶Department of Ophthalmology, Northern Jiangsu People's Hospital, Yangzhou, China.
⁷Department of Anesthesiology, the Affiliated hospital of Qingdao University, Qingdao, China.
⁸Department of Ophthalmology, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China.
⁹Administrative Office, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China.
¹⁰Huizhou first Maternal and Child Health Care Hospital, Huizhou, China.
¹¹Department of Ophthalmology, Jiangnan University Medical Center, Wuxi, China.
¹²Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
¹³Service of Endocrinology, Renhe Hospital, Baoshan District, Shanghai, China.
¹⁴Center of Clinical Research, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
¹⁵Department of Public Health, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

⁰Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, Nanjing, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.

Journal of Hazardous Materials +

|

October 5, 2024

View abstract on PubMed

Summary

Common air pollutants like carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone are linked to increased pediatric conjunctivitis (pink eye) risks. This study highlights potential public health benefits from air quality interventions for children's eye health.

Area Of Science

Environmental Health
Pediatric Ophthalmology
Epidemiology

Background

Evidence linking ambient gaseous pollutants to conjunctivitis is inconclusive, with limited research on pediatric populations.
Conjunctivitis, commonly known as pink eye, affects children globally, necessitating research into environmental risk factors.

Purpose Of The Study

To investigate the association between daily concentrations of ambient gaseous pollutants and outpatient visits for pediatric conjunctivitis.
To explore potential differences in susceptibility based on sex, age, and season.

Main Methods

A case-crossover study design was employed, analyzing data from 418,027 pediatric conjunctivitis outpatient visits in ten Chinese cities between 2013 and 2023.
Daily concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were assessed.
Statistical models, including two-pollutant and mixed-effects models, were used to evaluate the associations.

Main Results

A one standard deviation increase in daily CO, NO2, SO2, and O3 concentrations was associated with a significant increase in same-day pediatric conjunctivitis visits.
Specific increases were noted for CO (1.20%), NO2 (2.90%), SO2 (1.70%), and O3 (1.30%).
Stronger associations were observed in girls, children aged 1-5 years, and during summer months.

Conclusions

Ambient gaseous pollutants are associated with an increased risk of conjunctivitis in children.
Findings suggest that reducing exposure to air pollutants could benefit children's eye health.
Public health interventions targeting air quality may help mitigate pediatric conjunctivitis incidence.

Keywords:

Case-crossover Children Conjunctivitis Gaseous air pollution Outpatient visit

Related Concept Videos

Chronic Obstructive Pulmonary Disease

COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...