Assessing the disease burden of air pollution on children and adolescents in China from 1990 to 2019

Air pollution is a pressing concern in China, particularly its adverse effects on vulnerable populations such as children and adolescents. This study aimed to elucidate the disease burden in children and adolescents attributable to air pollution in geographical areas across China from 1990 to 2019. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 methodology to estimate disease burden attributable to air pollution in 33 areas of China, including provinces, autonomous regions, municipalities, and special administrative regions. In 2019, approximately 10,511 childhood deaths and 932,095 disability-adjusted life-years (DALYs) were attributable to air pollution in China. The DALYs was higher for boys and infants <1 year than it was for girls. Lower respiratory infections, neonatal preterm birth, and neonatal encephalopathy caused by birth asphyxia and trauma were the main air pollution-related diseases. The disease burden attributable to air pollution in children and adolescents decreased significantly from 1990 to 2019; with the average annual percent change (AAPC) of ?9��11% ([95%CI, ?9��61% to ?8��60%], P<0.001) for death rate, and ?9��09% ([?9��59% to ?8��58%], P<0.001) for DALYs rate. Disease burden attributable to air pollution in children and adolescents varied across provinces, with DALYs rate per 100,000 population ranged from 16��88 in Hong Kong to 2,152��54 in Tibet, peaking in the health area five. These findings highlight the necessity for province-specific research into the impacts of air pollution on childhood health in China, as well as improved air pollution control measures.