Effects of contamination and climate in the Pediatric Emergency Department visits for acute respiratory infection in the City of Buenos Aires

Arch Argent Pediatr. 2019 Dec 1;117(6):368-374. doi: 10.5546/aap.2019.eng.368.
[Article in English, Spanish]

Abstract

Introduction: Pollution and climate have an impact on pediatric respiratory diseases; few studies have assessed this in the Autonomous City of Buenos Aires.

Objective: To assess the impact of the interaction between air pollutants and climate on the Emergency Department visits for acute lower respiratory tract infection (ALRTI) in a children's hospital.

Methods: Ecological, time-series study with generalized additive models that included total visits and visits for ALRTI to the Emergency Department between 2012 and 2016. A series with 7-day moving averages for ALRTI visits was founded as a bias control measure. Predictors were daily levels of air pollutants (carbon monoxide, nitrous dioxide, particulate matter < 10 μ) and meteorological variables (temperature, humidity). Pollutants were measured at three monitoring stations. Temporal variables (day of the week, warm/cold semester) were controlled.

Results: There were 455 256 total visits; 17 298 accounted for visits for ALRTI. A correlation was established only between total visits and day of the week (Mondays and Saturdays, more visits; Thursdays, less visits). Less visits for ALRTI were recorded in the warm semester compared to the cold semester (relative risk = 0.23; 95 % confidence interval: 0.29-0.18; p < 0.001). One monitoring station did not show any correlation; the other two stations showed a weak correlation between carbon monoxide and particulate matter < 10 μ and visits for ALRTI.

Conclusion: The season accurately accounts for the increased number of total visits and visits for ALRTI. Although there was a correlation between the level of certain pollutants and the number of visits, its impact was irrelevant.

Keywords: air pollution; child; climate; respiratory tract infections.

Plain language summary

Introducción: La contaminación y el clima tienen impacto en la patología respiratoria en niños; pocos estudios lo evaluaron en la Ciudad de Buenos Aires. Objetivo: Evaluar el impacto de la interacción entre contaminantes atmosféricos y clima en las consultas por infección respiratoria aguda baja (IRAB) en un hospital pediátrico. Métodos: Estudio ecológico, de series temporales con modelos aditivos generalizados, que incluyó todas las consultas y consultas por IRAB (urgencias) entre 2012 y 2016. Para controlar sesgos, se conformó una serie con promedios móviles de 7 días para consultas por IRAB. Los predictores fueron niveles diarios de contaminantes atmosféricos (monóxido de carbono, dióxido nitroso, material particulado < 10 μ) y variables meteorológicas (temperatura, humedad). Los contaminantes fueron medidos en 3 estaciones de monitoreo. Se controló por variables temporales (día de la semana, semestre cálido/frío). Resultados: Las consultas totales fueron 455 256 y por IRAB 17 298. Solo consultas totales correlacionaron con día de la semana (lunes y sábados, más consultas y jueves, menos). El semestre cálido registró menos consultas por IRAB que el frío (riesgo relativo = 0,23; intervalo de confianza 95 %: 0,29-0,18; p < 0,001). Una estación de monitoreo no presentó ninguna correlación; las otras mostraron correlación débil entre monóxido de carbono y material particulado < 10 μ y consultas por IRAB. Conclusión: La época del año explica con precisión el incremento del número de consultas totales y por IRAB. Aunque el nivel de algunos contaminantes muestra correlación con el número de consultas, su impacto es irrelevante.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pollutants / analysis*
  • Argentina
  • Carbon Monoxide / analysis
  • Child
  • Cities
  • Climate
  • Emergency Service, Hospital / statistics & numerical data*
  • Environmental Exposure / analysis*
  • Hospitals, Pediatric
  • Humans
  • Nitrogen Dioxide / analysis
  • Particulate Matter / analysis
  • Respiratory Tract Infections / epidemiology*
  • Seasons
  • Time Factors

Substances

  • Air Pollutants
  • Particulate Matter
  • Carbon Monoxide
  • Nitrogen Dioxide