Abstract
ObjectiveTo examine the association of air pollutants with hospital admission for childhood asthma in Hong Kong.MethodsData on hospital admissions for asthma, influenza and total hospital admissions in children aged ≤18 years at all Hospital Authority hospitals during 1997–2002 were obtained. Data on daily mean concentrations of particles with aerodynamic diameter <10 μm (i. e. PM10) and <2.5 μm (i. e. PM2.5), nitrogen dioxide (NO2), sulphur dioxide (SO2), and ozone (O3) and data on meteorological variables were associated with asthma hospital admissions using Poisson's regression with generalized additive models for correction of yearly trend, temperature, humidity, day-of-week effect, holiday, influenza admissions and total hospital admission. The possibility of a lag effect of each pollutant and the interaction of different pollutants were also examined.ResultsThe association between asthma admission with change of NO2, PM10, PM2.5 and O3 levels remained significant after adjustment for multi-pollutants effect and confounding variables, with increase in asthma admission rate of 5.64% (3.21–8.14) at lag 3 for NO2, 3.67% (1.52–5.86) at lag 4 for PM10, 3.24% (0.93–5.60) at lag 4 for PM2.5 and 2.63% (0.64–4.67) at lag 2 for O3. Effect of SO2 was lost after adjustment.ConclusionAmbient levels of PM10, PM2.5, NO2 and O3 are associated with childhood asthma hospital admission in Hong Kong.
Highlights
MethodsData on hospital admissions for asthma, influenza and total hospital admissions in children aged 418 years at all Hospital Authority hospitals during 1997–2002 were obtained
There is substantial epidemiological evidence indicating a link between asthma morbidity including deterioration in lung functions, emergency department visits and hospital admission with outdoor air pollution levels [1]
It was generally believed that children are more vulnerable and susceptible than adults to air pollution exposure, [2] the PEACE project [3] which studied children aged 6–12 years in 28 regions of Europe, did not show any effects of particle matter, black smoke, sulphur dioxide (SO2) or nitrogen dioxide (NO2) on lung function, respiratory symptoms and bronchodilator use
Summary
Hong Kong is situated at the southeastern tip of China with a total area of 1102 km and a population of 6.816 million as of 2002. The core model included smooth function of the day of study, spline smooth functions of mean daily temperature and relative humidity, daily hospital admissions for influenza and total daily hospital c 2006 The Authors Journal compilation c 2006 Blackwell Publishing Ltd, Clinical and Experimental Allergy, 36 : 1138–1146 admission and indicator variables for day of the week and holidays to avoid over control for the effect of the pollutants and to account for the over-dispersion for the variable and possible population changes during the study period. ÃHighest percentage change after control for the mean daily temperature, relative humidity, daily hospital admissions for influenza, total daily hospital admission and indicator variables for day of the week and holidays
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