Association between air pollution and hospital admissions for upper respiratory tract infection among children in urban area, Malaysia

Abstract

BACKGROUND AND AIM: Recent epidemiological studies have discovered the short-term effect of air pollution on upper respiratory tract infection (URTI). However, few studies have evaluated air pollution association with hospital admissions for URTI among Malaysian children. This study investigates the association between ambient air pollution and children’s hospital admissions for URTI aged 0-17 years in Klang Valley, Malaysia, between 2010-2018. METHODS: Daily URTI hospital admissions among children from 14 hospitals in Klang Valley were obtained via the national electronic database. Data on daily ambient air pollution (PM10, SO2, NO2, CO and O3) were collected from 7 local monitoring stations. A Poisson generalised linear model was used to evaluate the lag effects (lag 0-7) between daily changes in air pollutants and numbers of URTI hospital admissions among children in 2010-2018, after controlling for the confounding effects of long-term trends, day of the week, public holidays and meteorological factors. The analysis was stratified by sex and age. RESULTS:Short-term exposure to PM10, SO2, NO2, and CO had significant positive effects on the number of children hospitalised with URTI. The excess risk (ER) of total children admitted to hospitals for URTI was significantly associated with SO2 at lag 2 days (ER 3.22%; CI 95% 0.01-6.53). The ER of girls hospitalised for URTI was associated with PM10, NO2 and CO with the highest ER for every 10 μg/m3 increase of the pollutants was 1.42% (CI 95% 0.00-2.86) at lag 0-4 days, 3.92% (CI 95% 1.06-6.87) at lag 0-5 days, and 0.19% (CI 95% 0.08-0.29) at lag 0-6 days, respectively. No significant associations were observed between air pollution and hospital admissions for URTI among boys and children age 10-17 years. CONCLUSIONS:This study showed that short-term exposure to air pollution was positively associated with increased URTI admissions among children in Klang Valley, Malaysia. KEYWORDS: air pollution, short-term exposure, respiratory diseases, children’s environmental health