Abstract
Pneumonia is a leading cause of childhood death. Few studies have investigated associations between residential ambient environmental exposures and pneumonia. In January–April 2015, we conducted a cross-sectional study in Shandong Province (China) and collected 9597 (response rate: 78.7%) parent-reported questionnaires for 3–6-year-old children from 69 urban kindergartens. We then selected 5640 children who had never changed residence since birth and examined associations between residential ambient traffic-related facilities and childhood pneumonia considering residential characteristics. Prevalence of doctor-diagnosed pneumonia during lifetime-ever was 25.9%. In the multivariate logistic regression analyses, residence close to a main traffic road (adjusted odds ratio, 95% confidence interval: 1.23, 1.08–1.40) and automobile 4S shop (1.76, 1.16–2.67) within 200 m, residence close to a filling station within 100 m (1.71, 1.10–2.65; reference: >200 m), as well as having a ground car park in the residential community (1.24, 1.08–1.42) were significantly associated with childhood pneumonia. The cumulative numbers of these traffic-related facilities had a positive dose-response relationship with the increased odds of childhood pneumonia. These associations and dose-response relationships were stronger among boys and among children with worse bedroom ventilation status during the night. Associations of residence close to the main traffic road and ground car parks in the residential community with childhood pneumonia were stronger among children living in the 1st–3rd floors than those living on higher floors. Similar results were found in the two-level (kindergarten-child) logistic regression analyses. Our findings indicate that living near traffic-related facilities is likely a risk factor for childhood pneumonia among urban children. The child’s sex, bedroom floor level, and bedroom ventilation could modify associations of ambient traffic-related facilities with childhood pneumonia.
Highlights
Pneumonia is a leading cause of childhood morbidity and mortality [1,2]
Another study found that indoor levels of polycyclic aromatic hydrocarbons (PAH) and carbon black (CB, an indicator of ambient heavy traffic) from ambient air declined with the increased floor level [54]. These findings suggested that increased odds of childhood pneumonia due to ambient traffic-related facilities could depend on the residence floor level, that could be related with the natural ventilation status and be associated with the household air quality [54,55]
Our findings seemingly suggested that traffic-related facilities had a greater impact on the increased odds of childhood pneumonia among children living on a low floor level than on a high floor of the residential building
Summary
Pneumonia is a leading cause of childhood morbidity and mortality [1,2]. In 2015, pneumonia caused about four million deaths and 35 million disability-adjusted life-years in children younger than five years of age [1,3].A series of studies have reported that ambient traffic-related air pollution, which are mainly indicated by nitrogen oxides (NOx ) and particulate matter with an aerodynamic diameter ≤10 μm (PM10 ), are associated with childhood pneumonia [4,5,6,7,8,9,10]. Pneumonia is a leading cause of childhood morbidity and mortality [1,2]. In 2015, pneumonia caused about four million deaths and 35 million disability-adjusted life-years in children younger than five years of age [1,3]. A series of studies have reported that ambient traffic-related air pollution, which are mainly indicated by nitrogen oxides (NOx ) and particulate matter with an aerodynamic diameter ≤10 μm (PM10 ), are associated with childhood pneumonia [4,5,6,7,8,9,10]. Res. Public Health 2018, 15, 1076; doi:10.3390/ijerph15061076 www.mdpi.com/journal/ijerph
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