Ambient PM2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study

Wenming Shi; Cong Liu; Isabella Annesi-Maesano; Dan Norback; Qihong Deng; Chen Huang; Hua Qian; Xin Zhang; Yuexia Sun; Tingting Wang; Aaron van Donkelaar; Randall V Martin; Yinping Zhang; Baizhan Li; Haidong Kan; Zhuohui Zhao

doi:10.1016/j.envint.2020.106176

Ambient PM_2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study

Environ Int. 2021 Jan:146:106176. doi: 10.1016/j.envint.2020.106176. Epub 2020 Nov 18.

Authors

Wenming Shi¹, Cong Liu¹, Isabella Annesi-Maesano², Dan Norback³, Qihong Deng⁴, Chen Huang⁵, Hua Qian⁶, Xin Zhang⁷, Yuexia Sun⁸, Tingting Wang⁹, Aaron van Donkelaar¹⁰, Randall V Martin¹¹, Yinping Zhang¹², Baizhan Li¹³, Haidong Kan¹⁴, Zhuohui Zhao¹⁵

Affiliations

¹ Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
² Epidemiology of Allergic and Respiratory Diseases Department, IPLESP, Sorbonne Université and INSERM, Medical School Saint-Antoine, F75012 Paris, France.
³ Department of Medical Sciences, Uppsala University, Uppsala SE-751, Sweden.
⁴ School of Energy Science and Engineering, Central South University, Changsha 410083, China.
⁵ School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China.
⁶ School of Energy & Environment, Southeast University, Nanjing 210096, China.
⁷ Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan 030006, China.
⁸ Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin University, Tianjin 300072, China.
⁹ School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China.
¹⁰ Department of Physics and Atmospheric Science, Dalhousie University, B3H 4R2 Halifax, Nova Scotia, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA.
¹¹ Department of Physics and Atmospheric Science, Dalhousie University, B3H 4R2 Halifax, Nova Scotia, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA; Atomic and Molecular Physics Division, Harvard-Smithsonian Center for Astrophysics, 60 Garden St, Cambridge, MA 02138, USA.
¹² Department of Building Science, Tsinghua University, Beijing 100084, China.
¹³ Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing 400030, China.
¹⁴ Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China. Electronic address: [email protected].
¹⁵ Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China. Electronic address: [email protected].

PMID: 33220537
DOI: 10.1016/j.envint.2020.106176

Abstract

The long-term effects of ambient PM_2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM_2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM_2.5, ozone and five main PM_2.5 constituents, including SO₄^2-, NO₃^-, NH₄⁺, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM_2.5 (per 10 µg/m³) and its constituents (per 1 µg/m³)-SO₄^2-, NO₃^-, NH₄⁺, and OM were 1.12 (95% CI:1.07-1.18), 1.02 (1.00-1.04), 1.06 (1.04-1.09), 1.05 (1.03-1.07) and 1.09 (1.06-1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM_2.5 and its constituents increased the risk of childhood pneumonia, especially NH₄⁺, NO₃^- and OM.

Keywords: Air pollution; Chemical constituents; Childhood pneumonia; Multi-level logistic regression; PM(2.5).

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Air Pollutants* / analysis
Air Pollution* / analysis
Child
Child, Preschool
China / epidemiology
Cities
Cross-Sectional Studies
Environmental Exposure / analysis
Humans
Particulate Matter / analysis
Pneumonia* / epidemiology

Substances

Air Pollutants
Particulate Matter