Air pollution and child respiratory health: a case-crossover study in Australia and New Zealand.
BACKGROUND
The strength of the association between outdoor air pollution and hospital admissions in children has not yet been well defined.


OBJECTIVE
To estimate the impact of outdoor air pollution on respiratory morbidity in children after controlling for the confounding effects of weather, season, and other pollutants.


METHODS
The study used data on respiratory hospital admissions in children (three age groups: < 1, 1-4, and 5-14 years) for five cities in Australia and two in New Zealand. Time series of daily numbers of hospital admissions were analyzed using the case-crossover method; the results from cities were combined using a random-effects meta-analysis.


RESULTS
Significant increases across the cities were observed for hospital admissions in children for pneumonia and acute bronchitis (0, 1-4 years), respiratory disease (0, 1-4, 5-14 years), and asthma (5-14 years). These increases were found for particulate matter with a diameter less than 2.5 microm (PM2.5) and less than 10 microm (PM10), nephelometry, NO2, and SO2. The largest association found was a 6.0% increase in asthma admissions (5-14 years) in relation to a 5.1-ppb increase in 24-hour NO2.


CONCLUSIONS
This study found strong and consistent associations between outdoor air pollution and short-term increases in childhood hospital admissions. A number of different pollutants showed significant associations, and these were distinct from any temperature (warm or cool) effects.
Barnett
Adrian G
AG
School of Population Health, University of Queensland, Herston, Australia.
Williams
Gail M
GM
Schwartz
Joel
J
Neller
Anne H
AH
Best
Trudi L
TL
Petroeschevsky
Anna L
AL
Simpson
Rod W
RW
D000293:Adolescent; D017677:Age Distribution; D000397:Air Pollution / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D015984:Causality; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009520:New Zealand / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012621:Seasons