1. Does Exposure to Air Pollution Increase the Risk of Acute Care in Young Children with Asthma? An Ontario, Canada Study
- Author
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Ivy Fong, Randall V. Martin, Sharon Dell, Lauren Pinault, Emilie Terebessy, Kimball Zhang, Richard Ménard, Michael Jerrett, Aaron van Donkelaar, Jingqin Zhu, Teresa To, Dave Stieb, Perry Hystad, Jeffrey R. Brook, and Alain Robichaud
- Subjects
medicine.medical_specialty ,Nitrogen Dioxide ,010501 environmental sciences ,01 natural sciences ,Biochemistry ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Ozone ,Interquartile range ,Acute care ,Environmental health ,Air Pollution ,medicine ,Humans ,030212 general & internal medicine ,Poisson regression ,Child ,0105 earth and related environmental sciences ,General Environmental Science ,Asthma ,Ontario ,Air Pollutants ,business.industry ,Confounding ,Infant, Newborn ,Emergency department ,Environmental Exposure ,medicine.disease ,Confidence interval ,Child, Preschool ,symbols ,Population study ,Particulate Matter ,business - Abstract
Owing to their greater outdoor activity and ongoing lung development, children are particularly vulnerable to the harmful effects of exposure to fine particulate matter (PM2.5). However, the effects of PM2.5 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 PM2.5 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 PM2.5 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 (SO4) 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 (NO2) and ozone (O3). In multi-pollutant models with oxidants, the adjusted RRs for SO4 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 SO4 component of PM2.5 were above one, none were statistically significant. This study found significant associations with exposure to SO4 in PM2.5 and all-cause acute care, chiefly for hospitalizations, in children with asthma.
- Published
- 2021