title: Air pollution and children's asthma-related emergency hospital visits in southeastern France.
abstract: Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM10and PM2.5, meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM10measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor.
  
  
  CONCLUSIONS
  PM10and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.
authors.affiliation: Pediatric Pulmonology Department, Timone Children's Hospital, 264 rue Saint Pierre, 13005, Marseille, France. julie.mazenq@ap-hm.fr.
authors.forename: Julie
authors.initials: J
authors.lastname: Mazenq
authors.affiliation: Pediatric Pulmonology Department, Timone Children's Hospital, 264 rue Saint Pierre, 13005, Marseille, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
authors.affiliation: Aix-Marseille University, UMR912 SESSTIM (AMU-IRD-INSERM), Marseille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
authors.affiliation: Pulmonology and Allergology Department, Hôpital Nord, Marseille, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Charpin
authors.affiliation: IRD French Institute of Research for Development, EHESP, French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille University, Marseille, France.|University Mediterranean Hospital Institute for Infections, Marseille, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Nougairede
authors.affiliation: Regional Emergencies Observatory, Provence-Alpes-Cote d'Azur region (ORU PACA), Hyères, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Viudes
authors.affiliation: Regional Emergencies Observatory, Provence-Alpes-Cote d'Azur region (ORU PACA), Hyères, France.|Pediatric Emergency Department, Hôpital Nord, Marseille, France.
authors.forename: Guilhem
authors.initials: G
authors.lastname: Noel
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis / Q000706:statistics & numerical data; D001249:Asthma / Q000209:etiology* / Q000628:therapy; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D065840:Protective Factors; D012111:Residence Characteristics; D012307:Risk Factors; D014887:Weather
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Air pollution; Asthma; Children