The short-term association between environmental variables and daily pediatric asthma patient visits in Hangzhou, China: A time-series study
Yuqing Feng,
Xin Yang,
Yingshuo Wang,
Lei Wu,
Qiang Shu,
Haomin Li
Affiliations
Yuqing Feng
Department of Data and Information, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
Xin Yang
Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China; Department of Genetics and Metabolism, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
Yingshuo Wang
Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
Lei Wu
Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China; Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
Qiang Shu
Department of Data and Information, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China; Corresponding author. Binsheng Road 3333, Hangzhou, Zhejiang, 310052, China.
Haomin Li
Department of Data and Information, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China; Corresponding author. Binsheng Road 3333, Hangzhou, Zhejiang, 310052, China.
Background: To date, a large number of studies have shown correlations between environmental variables and pediatric asthma in short-term lag time. However, their results are inconsistent. Therefore, we aimed to evaluate the short-term impact of environmental variables on daily pediatric asthma patients’ visits (DPAPV) in Hangzhou, China, and find the most important risk factor. Methods: Generalized additive distribution lag non-linear model (GAM-DLNM) was applied to explore the effect of environmental variables on DPAPV in single- and multi-variable models in Hangzhou, China from 2014 to 2021. Then, risk factors of pediatric asthma were selected (p < 0.05 both in single- and multi-variable models) and used weighted quantile sum (WQS) regression model to evaluate their relative importance. Results: There were 313,296 pediatric asthma patient records between 2014 and 2021. Both in single- and multi-variable models, PM2.5, PM10, and NO2 exhibited significant positive correlations in short-term lag time and these correlations reached their maximum in lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), and lag day 3 (RR = 1.04, 95%CI:1.02 to1.05), respectively. The WQS index showed that NO2 had the greatest relative importance (weight over 70 %). The relative importance of NO2 increased with time passing. Males were more susceptible to the adverse effects of NO2. Conclusion: PM2.5, PM10, and NO2 had significant adverse effects on pediatric asthma. Among them, NO2 presented the greatest and most important adverse effect on the disease. Therefore, parents could give priority to paying attention to NO2 to control children's asthma.
