Acute effects of ambient air pollution on lower respiratory infections in Guangzhou children of China

Abstract Background Daily concentrations of air pollution are associated with lower respiratory diseases. This study investigated the short-term association of ambient air pollution with daily hospital admissions due to pneumonia among children aged 0–17 in Guangzhou city of China. Methods Daily ambient air pollution concentrations were extracted from the databases of the Chinese Environmental Monitoring Center. Children hospital admission counts for pneumonia during 2013–2018 were sourced from the Guangdong Maternal and Child Healthcare Hospital. Associations between outdoor air pollution levels and hospital admissions were estimated for time lags of zero up to seven days using Quasi-Poisson regression models, adjusted for seasonal variations, meteorological variables, day of week and holidays. The associations between clinical pathogenic microorganism inspection results for pneumonia and air pollutants were calculated using Lasso regression models. Results Ambient air pollutants were all positively associated with children hospital admissions due to pneumonia of all ages. Significant associations were found for air pollutants except for inhalable particulate matter (PM) \(\le\)10 µm in aerodynamic diameter (PM 10 ) in children aged 0–17 years. Increments of an interquartile range (IQR) (279.10µg/m 3 and 28.42µg/m 3 , respectively) in the 7-day-average level of carbon monoxide (CO) and nitrogen dioxide (NO 2 ) were associated with a 26.17% (95% confidence interval (CI) 1.40%-56.98%) and 25.09% (95%CI 0.54%-55.64%) increase in pneumonia hospitalizations for children aged 6–17, respectively. An IQR increase in CO concentrations (279.10µg/m 3 ) was associated with a 15.15% (95%CI 4.34%-27.08%) increase in pneumonia hospitalizations for children aged 1–5. Estimates for CO were statistically significant among children aged 1–5 years in summer. The associations remained stable in two-pollutant models. Daily cases of microbial detection for pneumonia were positively associated with daily NO 2 concentration. The pneumonia hospitalizations due to Mycoplasma pneumonia , Flu A virus and Flu B virus , the predominant pathogenic microorganisms detected in children aged 0–5 are apparently associated with levels of PMs, CO, NO 2 and O 3 . Conclusions Strong associations among hospital admissions for lower respiratory infections, pathogenic microorganisms and daily levels of air pollution confirm the urgent need to adopt sustainable improving ambient air quality policies in Guangzhou city to protect children's health.