期刊
INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH
卷 229, 期 -, 页码 -出版社
ELSEVIER GMBH
DOI: 10.1016/j.ijheh.2020.113571
关键词
Bronchiolitis; Bronchitis; Causal inference method; Difference-in-differences; Fine particulate matter; Upper respiratory infection
资金
- National Health Insurance Service of the Republic of Korea (Big Data Utilization Specialist Program)
- National Strategic Project-Fine Particle of the National Research Foundation (NRF) of Korea - Ministry of Science and ICT
- Ministry of Health and Welfare [NRF-2017M3D8A1092008, NRF-2017M3D8A1092009]
- Basic Science Research Program of the NRF - Ministry of Science and ICT [NRF-2017R1E1A1A03071123]
- Ministry of Environment
Background: Previous studies on the association between fine particulate matter (PM2.5) exposure and acute respiratory infection in children are scarce and present inconsistent results. We estimated the association between short-term PM2.5 exposure and acute respiratory infection among children aged 0-4 years using a difference-in-differences approach. Methods: We used data on the daily PM2.5 concentrations, hospital admissions for acute respiratory infection, and meteorological factors of the 15 regions in the Republic of Korea (2013-2015). To estimate the cumulative effects, we used a difference-in-differences approach generalized to multiple spatial units (regions) and time periods (day) with distributed lag non-linear models. Results: With PM2.5 levels of 20.0 mu g/m(3) as a reference, PM2.5 levels of 30.0 mu g/m(3) were positively associated with the risk of acute upper respiratory infection (relative risk (RR) = 1.048, 95% confidence interval (CI): 1.028, 1.069) and bronchitis or bronchiolitis (RR = 1.060, 95% CI: 1.038, 1.082) but not with the risk of acute lower respiratory infection and pneumonia. PM2.5 levels of 40.0 mu g/m(3) were also positively associated with the risk of acute upper respiratory infection (RR = 1.083, 95% CI: 1.046, 1.122) and bronchitis or bronchiolitis (RR = 1.094, 95% CI: 1.054, 1.136). Conclusions: We found the associations of short-term PM2.5 exposure with acute upper respiratory infection and bronchitis or bronchiolitis among children aged 0-4 years. As causal inference methods can provide more convincing evidence of the effects of PM2.5 levels on respiratory infections, public health policies and guidelines regarding PM2.5 need to be strengthened accordingly.
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