Abstract

This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.

Highlights

  • Asthma is a chronic inflammatory airway disease, characterized by coughing, wheezing, dyspnea and chest tightness, that may originate in early life [1]; it is a global problem affecting approximately10% of children worldwide, with huge individual and societal burden

  • Among children under 18 years of age, we observed significant increases in asthma hospitalization with interquartile range increases in PM2.5 (RR = 1.156; CI = 1.142–1.170; p < 0.001), particulate matter ≤10 μm (PM10) (RR = 1.120; CI = 1.107–1.134; p < 0.001), SO2 (RR = 1.367; CI = 1.349–1.385; p < 0.001) and NO2 (RR = 1.065; CI = 1.053–1.076; p < 0.001), with the strongest effect estimate being observed for SO2, while O3 (RR = 0.969; CI = 0.957–0.981; p < 0.001) was negatively associated with asthma hospitalization in the univariate Poisson regression

  • It is important to note that of all the pollutants examined, SO2 was most strongly associated with daily asthma hospitalizations in children

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Summary

Introduction

Asthma is a chronic inflammatory airway disease, characterized by coughing, wheezing, dyspnea and chest tightness, that may originate in early life [1]; it is a global problem affecting approximately. 10% of children worldwide, with huge individual and societal burden. Asthma is one of the major reasons for school absence, emergency medical treatment, and hospitalization during childhood [2]. Asthma hospitalization represents a serious adverse outcome that is theoretically preventable with. Res. Public Health 2019, 16, 203; doi:10.3390/ijerph16020203 www.mdpi.com/journal/ijerph

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