Impact of air pollutants on pediatric admissions for Mycoplasma pneumonia: a cross-sectional study in Shanghai, China

• Published in: BMC public health 2020-04, Vol.20 (1), p.447-9, Article 447
• Main Authors: Chen, Ning, Shi, Jianwei, Huang, Jiaoling, Yu, Wenya, Liu, Rui, Gu, Li, Yang, Rong, Yu, Zhaohu, Liu, Qian, Yang, Yan, Cui, Sainan, Wang, Zhaoxin
• Format: Article
• Language: English
• Subjects: Air pollutants; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Air Pollution - analysis; Air pollution effects; Analysis; Carbon monoxide; Carbon Monoxide - analysis; Carbon Monoxide - toxicity; Child; Child health; Children; Children health; Children's hospitals; China - epidemiology; Cities; Confidence intervals; Cross-Sectional Studies; Environmental aspects; Environmental Monitoring; Environmental protection; Female; Fine particles; Health facilities construction; Hospitalization - statistics & numerical data; Hospitals; Hospitals, Pediatric - statistics & numerical data; Humans; Humidity; Levels; Logistic Models; Male; Mycoplasma; Mycoplasma pneumonia; Nitrogen dioxide; Nitrogen Dioxide - analysis; Nitrogen Dioxide - toxicity; Odds Ratio; Ozone; Ozone - analysis; Ozone - toxicity; Particulate emissions; Particulate matter; Particulate Matter - analysis; Particulate Matter - toxicity; Pathogens; Pediatrics; Pneumonia; Pneumonia, Mycoplasma - epidemiology; Pneumonia, Mycoplasma - etiology; Pollutants; Public health; Seasonal variations; Statistical analysis; Streptococcus infections; Studies; Sulfur; Sulfur compounds; Sulfur dioxide; Sulfur Dioxide - analysis; Sulfur Dioxide - toxicity; Teenagers; Variables; Weather
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-020-8423-4

Children are especially vulnerable to pneumonia and the effects of air pollution. However, little is known about the impacts of air pollutants on pediatric admissions for Mycoplasma pneumonia. This study was conducted to investigate the impacts of air pollutants on pediatric hospital admissions for Mycoplasma pneumonia in Shanghai, China. A cross-sectional design was applied to explore the association between pediatric hospital admissions and levels of air pollutants (fine particulate matter, particulate matter, ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide). Data on hospital admissions for pneumonia and levels of ambient air pollutants were obtained for the period of 2015 to 2018. Associations between pediatric admissions for Mycoplasma pneumonia and ambient air pollutants were calculated using logistic regression and described by the odds ratio and relevant 95% confidence interval. The hysteresis effects of air pollutants from the day of hospital admission to the previous 7 days were evaluated in single-pollutant models and multi-pollutant models with adjustments for weather variables and seasonality. Lag 0 was defined as the day of hospital admission, lag 1 was defined as the day before hospital admission, and so forth. In the single-pollutant models (without adjustment for other pollutants), pediatric hospital admissions for pneumonia were positively associated with elevated concentrations of nitrogen dioxide and fine particulate matter. A 0.5% increase in daily admissions per 10-μg/m increase in the nitrogen dioxide level occurred at lag 1 and lag 2, and a 0.3% increase in daily admissions per 10-μg/m increase in fine particulate matter occurred at lag 1. In the multi-pollutant models, nitrogen dioxide and fine particulate matter remained significant after inclusion of particulate matter, ozone, sulfur dioxide, and carbon monoxide. This study illustrated that higher levels of nitrogen dioxide and fine particulate matter increase the risk of pediatric hospitalization for Mycoplasma pneumonia in Shanghai, China. These findings imply that the high incidence of Mycoplasma pneumonia in children in Asia might be attributed to the high concentration of specific air pollutants in Asia.