Associations of ambient air pollution and daily outpatient visits for pediatric atopic dermatitis in Shanghai, China

Lijuan Liu; Cong Liu; Renjie Chen; Rui Feng; Yufeng Zhou; Libo Wang; Jianguo Hong; Lanfang Cao; Yanming Lu; Xiaoyan Dong; Min Xia; Bo Ding; Liling Qian; Wenhao Zhou; Yonghao Gui; Wen He; Qing Wang; Xiao Han; Aizhen Lu; Xiaobo Zhang

Ecotoxicology and Environmental Safety (Nov 2024)

Associations of ambient air pollution and daily outpatient visits for pediatric atopic dermatitis in Shanghai, China

Lijuan Liu,
Cong Liu,
Renjie Chen,
Rui Feng,
Yufeng Zhou,
Libo Wang,
Jianguo Hong,
Lanfang Cao,
Yanming Lu,
Xiaoyan Dong,
Min Xia,
Bo Ding,
Liling Qian,
Wenhao Zhou,
Yonghao Gui,
Wen He,
Qing Wang,
Xiao Han,
Aizhen Lu,
Xiaobo Zhang

Affiliations

Lijuan Liu: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Cong Liu: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
Renjie Chen: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
Rui Feng: Shanghai Key Laboratory of Intelligent Information Processing, School of Computer Science, Fudan University, Shanghai 200433, China
Yufeng Zhou: Institute of Pediatrics, Children’s Hospital of Fudan University, National Children’s Medical Center, and the Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China
Libo Wang: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Jianguo Hong: Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China
Lanfang Cao: Department of Pediatrics, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
Yanming Lu: Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201112, China
Xiaoyan Dong: Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai 200062, China
Min Xia: Department of Pediatrics, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
Bo Ding: Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201112, China
Liling Qian: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Wenhao Zhou: Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510515, China
Yonghao Gui: Cardiovascular Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Wen He: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Qing Wang: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
Xiao Han: Institute of Pediatrics, Children’s Hospital of Fudan University, National Children’s Medical Center, and the Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China
Aizhen Lu: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China; Correspondence to: No. 399 Wanyuan Road, Shanghai 201102, China
Xiaobo Zhang: Department of Respiratory Medicine, Children’s Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China; Correspondence to: No. 399 Wanyuan Road, Shanghai 201102, China

Journal volume & issue: Vol. 286
p. 117231

Abstract

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Limited evidence was available on ambient air pollution and pediatric atopic dermatitis (AD). The study aimed to evaluate the associations between short-term exposure to air pollutants and outpatient visits for pediatric AD. From 2016–2018, we collected data on six criteria air pollutants (PM2.5, PM10, NO2, SO2, CO and O3) and daily outpatient visits for pediatric AD in 66 hospitals, covering all districts in Shanghai, China. The over-dispersed Poisson generalized additive model (GAM) was applied to fit the associations of criteria air pollutants with hospital visits. Two-pollutant models were fitted and stratified analyses by sex, age and season were conducted. We identified 477,833 outpatient visits for pediatric AD. Each interquartile range (IQR) increase in PM2.5 (IQR: 30.9 μg/m3), PM10 (8.9 μg/m3), NO2 (25.5 μg/m3), SO2 (5.8 μg/m3) and CO (0.283 mg/m3) on the concurrent day was significantly associated with increments of 2.08 % (95 % CI: 0.53 %, 3.65 %), 2.53 % (95 % CI: 0.87 %, 4.22 %), 8.14 % (95 % CI: 6.24 %, 10.08 %), 5.67 % (95 % CI: 3.58 %, 7.80 %), and 2.27 % (95 % CI: 0.70 %, 3.87 %) in pediatric AD outpatient visits, respectively. The effects of NO2 remained robust after adjustment for other air pollutants. The exposure-response curves for PM2.5 and PM10 were steeper for moderate-lower concentrations, with a flatten curves at high concentration; nearly linear relationships were found for NO2. Higher associations of NO2 exposure on AD were detected in children under 6 years old (p=0.01); and we observed larger effect of air pollutants in cool seasons (p<0.001 for PM2.5, PM10, NO2 and CO; p=0.043 for SO2). This study indicated that short-term exposure to air pollution could increase risk of outpatient visits for pediatric AD.

Published in Ecotoxicology and Environmental Safety

ISSN: 0147-6513 (Print); 1090-2414 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Technology: Environmental technology. Sanitary engineering: Environmental pollution; Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/ecotoxicology-and-environmental-safety

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