Does exposure to air pollution increase the risk of acute care in young children with asthma? An Ontario, Canada study.

Autor: To T; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Canada; Dalla Lana School of Public Health, University of Toronto, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada. Electronic address: teresa.to@sickkids.ca., Zhu J; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada., Terebessy E; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Canada., Zhang K; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada., Fong I; Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Canada., Pinault L; Health Analysis Division, Statistics Canada., Jerrett M; The University of California, Los Angeles, Fielding School of Public Health, CA, USA., Robichaud A; Air Quality Research Division, Environment and Climate Change Canada., Ménard R; Air Quality Research Division, Environment and Climate Change Canada., van Donkelaar A; Department of Physics and Atmospheric Science, Dalhousie University, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA., Martin RV; Department of Physics and Atmospheric Science, Dalhousie University, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA; Harvard-Smithsonian Center for Astrophysics, USA., Hystad P; College of Public Health and Human Sciences, Oregon State University, USA., Brook JR; Dalla Lana School of Public Health, University of Toronto, Canada., Dell S; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Canada; Pediatric Respiratory Medicine, Provincial Health Services Authority, BC Children's Hospital, Canada., Stieb D; Environmental Health Science and Research Bureau, Health Canada, Canada.
Jazyk: angličtina
Zdroj: Environmental research [Environ Res] 2021 Aug; Vol. 199, pp. 111302. Date of Electronic Publication: 2021 May 19.
DOI: 10.1016/j.envres.2021.111302
Abstrakt: Owing to their greater outdoor activity and ongoing lung development, children are particularly vulnerable to the harmful effects of exposure to fine particulate matter (PM 2.5 ) . However, the effects of PM 2.5 components are poorly understood. This study aimed to use a longitudinal birth cohort of children with physician-diagnosed incident asthma to investigate the effect of PM 2.5 components at birth on morbidity measured by health services utilization. Of 1277 Toronto Child Health Evaluation Questionnaire (T-CHEQ) participants, the study population included 362 children diagnosed with asthma who were followed for a mean of 13 years from birth until March 31, 2016, or loss-to-follow-up. Concentrations of PM 2.5 and its components were assigned based on participants' postal codes at birth. Study outcomes included counts of asthma, asthma-related, and all-cause health services use. Poisson regression in single-, two-, and multi-pollutant models was used to estimate rate ratios (RR) per interquartile range (IQR) increase of exposures. Covariates were included in all models to further adjust for potential confounding. The adjusted RR for sulfate (SO 4 ) and all-cause hospitalizations was statistically significant with RR = 2.23 (95% confidence interval [CI]: 1.25-3.96) in a multi-pollutant model with nitrogen dioxide (NO 2 ) and ozone (O 3 ). In multi-pollutant models with oxidants, the adjusted RRs for SO 4 of all-cause hospitalizations and emergency department (ED) visits were also statistically significant with RR = 2.31 (95% CI: 1.32-4.03) and RR = 1.39 (95% CI: 1.02-1.90), respectively. While unadjusted single-pollutant RRs for asthma-specific and asthma-related health services use with the SO 4 component of PM 2.5 were above one, none were statistically significant. This study found significant associations with exposure to SO 4 in PM 2.5 and all-cause acute care, chiefly for hospitalizations, in children with asthma.
(Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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