Ambient PM2.5 and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study

[Display omitted] •Long-term exposure to ambient PM2.5 increased the risks of childhood pneumonia.•NO3−, NH4+ and OM dominated the health effects of PM2.5 on pneumonia in children.•Children in urban areas and breastfeeding < 6 months had higher risks of pneumonia.•Children aged < 5 yrs enhance...

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Published in:	Environment international Vol. 146; p. 106176
Main Authors:	Shi, Wenming, Liu, Cong, Annesi-Maesano, Isabella, Norback, Dan, Deng, Qihong, Huang, Chen, Qian, Hua, Zhang, Xin, Sun, Yuexia, Wang, Tingting, van Donkelaar, Aaron, Martin, Randall V., Zhang, Yinping, Li, Baizhan, Kan, Haidong, Zhao, Zhuohui
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01.01.2021 Elsevier
Subjects:	Air pollution breast feeding carbon Chemical constituents childhood Childhood pneumonia China cross-sectional studies demographic statistics Ecology, environment environment Health Human health and pathology Life Sciences Multi-level logistic regression odds ratio organic matter ozone Pediatrics PM2.5 pneumonia Pulmonology and respiratory tract regression analysis risk Santé publique et épidémiologie satellites urban areas China Air pollution Childhood pneumonia Multi-level logistic regression Chemical constituents PM2.5
ISSN:	0160-4120, 1873-6750, 1873-6750
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Summary:	[Display omitted] •Long-term exposure to ambient PM2.5 increased the risks of childhood pneumonia.•NO3−, NH4+ and OM dominated the health effects of PM2.5 on pneumonia in children.•Children in urban areas and breastfeeding < 6 months had higher risks of pneumonia.•Children aged < 5 yrs enhanced the risk of pneumonia when exposure to ambient PM2.5. The long-term effects of ambient PM2.5 and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM2.5 constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM2.5, ozone and five main PM2.5 constituents, including SO42−, NO3−, NH4+, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM2.5 (per 10 µg/m3) and its constituents (per 1 µg/m3)-SO42−, NO3−, NH4+, and OM were 1.12 (95% CI:1.07–1.18), 1.02 (1.00–1.04), 1.06 (1.04–1.09), 1.05 (1.03–1.07) and 1.09 (1.06–1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM2.5 and its constituents increased the risk of childhood pneumonia, especially NH4+, NO3− and OM.
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ISSN:	0160-4120 1873-6750 1873-6750
DOI:	10.1016/j.envint.2020.106176