Air pollution, aeroallergens, and emergency room visits for acute respiratory diseases and gastroenteric disorders among young children in six Italian cities.
BACKGROUND
Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0-2 years of age.


METHODS
We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case-crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis.


RESULTS
CO and SO(2) were most strongly associated with wheezing, with a 2.7% increase [95% confidence interval (CI), 0.5-4.9] for a 1.04-microg/m(3) increase in 7-day average CO and a 3.4% (95% CI, 1.5-5.3) increase for an 8.0-microg/m(3) increase in SO(2). Positive associations were also found for PM with aerodynamic diameter < or = 10 microg and NO(2). We found a significant association between the 3-day moving average CO and gastroenteric disorders [3.8% increase (95% CI, 1.0-6.8)]. When data were stratified by season, the associations were stronger in summer for wheezing and in winter for gastroenteric disorders.


CONCLUSIONS
Air pollution is associated with triggering of wheezing and gastroenteric disorders in children 0-2 years of age; more work is needed to understand the mechanisms to help prevent wheezing in children.
Orazzo
Flavia
F
Pediatric Emergency Room, Santobono's Hospital, Naples, Italy.
Nespoli
Luigi
L
Ito
Kazuhiko
K
Tassinari
Davide
D
Giardina
Daniela
D
Funis
Maurizio
M
Cecchi
Alessandra
A
Trapani
Chiara
C
Forgeschi
Gisella
G
Vignini
Massimo
M
Nosetti
Luana
L
Pigna
Sabrina
S
Zanobetti
Antonella
A
D000208:Acute Disease; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D000485:Allergens / Q000276:immunology; D002248:Carbon Monoxide / Q000032:analysis / Q000633:toxicity; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity; D012135:Respiratory Sounds / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D013458:Sulfur Dioxide / Q000032:analysis / Q000633:toxicity
D000393:Air Pollutants; D000485:Allergens; D052638:Particulate Matter; D013458:Sulfur Dioxide; D002248:Carbon Monoxide