Ambient PM2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study

• Published in: Environment international Vol. 146; p. 106176
• Main Authors: Shi, Wenming, Liu, Cong, Annesi-Maesano, Isabella, Norback, Dan, Deng, Qihong, Huang, Chen, Qian, Hua, Zhang, Xin, Sun, Yuexia, Wang, Tingting, van Donkelaar, Aaron, Martin, Randall V., Zhang, Yinping, Li, Baizhan, Kan, Haidong, Zhao, Zhuohui
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.01.2021; Elsevier
• Subjects: Air pollution; Chemical constituents; Childhood pneumonia; Ecology, environment; Health; Human health and pathology; Life Sciences; Multi-level logistic regression; Pediatrics; PM2.5; Pulmonology and respiratory tract; Santé publique et épidémiologie; Air pollution; Childhood pneumonia; Multi-level logistic regression; Chemical constituents; PM2.5
• ISSN: 0160-4120; 1873-6750
• DOI: 10.1016/j.envint.2020.106176

[Display omitted] •Long-term exposure to ambient PM2.5 increased the risks of childhood pneumonia.•NO3−, NH4+ and OM dominated the health effects of PM2.5 on pneumonia in children.•Children in urban areas and breastfeeding < 6 months had higher risks of pneumonia.•Children aged < 5 yrs enhanced the risk of pneumonia when exposure to ambient PM2.5. The long-term effects of ambient PM2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM2.5, ozone and five main PM2.5 constituents, including SO42−, NO3−, NH4+, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM2.5 (per 10 µg/m3) and its constituents (per 1 µg/m3)-SO42−, NO3−, NH4+, and OM were 1.12 (95% CI:1.07–1.18), 1.02 (1.00–1.04), 1.06 (1.04–1.09), 1.05 (1.03–1.07) and 1.09 (1.06–1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM2.5 and its constituents increased the risk of childhood pneumonia, especially NH4+, NO3− and OM.