title: Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions.
abstract: In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of Sao Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 microg/m3) in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3) in emergency room visits due to lower respiratory tract diseases (4-day moving average), a 17.6% increase (95% CI = 3.3-32.7) in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average), and a 31.4% increase (95% CI = 7.2-55.7) in hospital admissions due to asthma or bronchiolitis (2-day moving average). The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.
authors.affiliation: Laboratório de Poluição Atmosférica Experimental, Departamento de Patologia (LIM05), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. sylviaclf@icr.hcnet.usp.br
authors.forename: S C L
authors.initials: SC
authors.lastname: Farhat
authors.forename: R L P
authors.initials: RL
authors.lastname: Paulo
authors.forename: T M
authors.initials: TM
authors.lastname: Shimoda
authors.forename: G M S
authors.initials: GM
authors.lastname: Conceição
authors.forename: C A
authors.initials: CA
authors.lastname: Lin
authors.forename: A L F
authors.initials: AL
authors.lastname: Braga
authors.forename: M P N
authors.initials: MP
authors.lastname: Warth
authors.forename: P H N
authors.initials: PH
authors.lastname: Saldiva
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016012:Poisson Distribution; D011446:Prospective Studies; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*