Short-term increases in air pollution associated with rise in pneumonia in children
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Short-term increases in ambient air pollution were associated with a rise in the incidence of pneumonia in children, according to a large, community-based study in Bangladesh.
The Stanford-led study highlights a link between fine particulate matter and child health in South Asia, a region with elevated levels of air pollution and more than 40% of the global pneumonia cases, according to a press release. The results, published in Environmental Pollution, estimate the effect of increased fine particulate matter on pneumonia hospitalizations in children is about twice as much as previously thought, and indicates that a particular industry may play a role, according to the release.
“There is widespread interest in identifying the components of [fine particulate matter] that drive health effects to support more targeted pollution reduction,” Allison R. Sherris, MD, a PhD candidate at Emmett Interdisciplinary Program in Environment and Resources at Stanford University, and colleagues wrote in Environmental Pollution. “However, identifying source-specific health impacts at a population level has been a major methodological challenge. Many common statistical approaches are complicated by correlation between sources, as well as between each source and total [fine particulate matter] mass.”
The exploratory analysis evaluated health surveillance data on all children aged 5 years and younger in Bangladesh from 2005 to 2014. Researchers obtained twice-weekly source-appointed ambient fine particulate matter (PM2.5) measurements during the same period.
Of 28,089 clinic visits included in this analysis, 17,219 resulted in a pneumonia diagnosis and 10,870 resulted in an upper respiratory infection diagnosis.
A 10 µg/m3 increase in 2-day lagged PM2.5 was associated with a 3.2% increase in the incidence of pneumonia (RR = 1.032; 95% CI, 1.008-1.056).
There was no significant association between PM2.5 and diagnoses of upper respiratory infections (RR = 1.018; 95% CI, 0.991-1.045). However, researchers observed a stronger association between PM2.5 and upper respiratory infection on days when ambient PM2.5 had a higher mass percent associated with brick kiln and fugitive lead emissions. Two-day lagged 10 µg/m3 PM2.5 increases associated with brick kiln (RR = 1.083; 95% CI, 1.035-1.141) and fugitive lead (RR = 1.081; 95% CI, 1.028-1.143) were associated with an 8% increase in the incidence of pneumonia in stratified analyses.
Further research on the health effects of brick kiln and other source particles could aid in informing health and environmental interventions worldwide, according to the release.
“Further research on this topic in South Asia would advance efforts to reduce the high burden of respiratory illness through targeted emission reduction,” the researchers wrote.