Outdoor particulate air pollution and indoor renovation associated with childhood pneumonia in China

摘要

AbstractBackgroundPneumonia is a common early-childhood respiratory infection that leads to long-term health impacts, but its risk factors remain unclear.ObjectiveTo examine the association between early life exposure to both outdoor and indoor air pollution and childhood pneumonia.MethodsWe conducted a retrospective cohort study of 2598 children aged 3–6 years in Changsha, China (2011-2012). Children's life-time prevalence of pneumonia and exposure to indoor air pollution related to home renovation were surveyed by a questionnaire answered by the parents. Children's exposure to outdoor air pollution, including nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), was estimated using the measured concentrations at monitoring stations. Association between childhood pneumonia and exposure to indoor and outdoor air pollution during both prenatal and postnatal periods were examined by using logistic regression model in terms of odds ratio (OR) and 95% confidence interval (CI).ResultsLife-time prevalence of pneumonia in preschool children in Changsha is high, up to 38.6%.We found that childhood pneumonia was associated with postnatal exposure to outdoor particulate air pollutant PM10, adjusted OR (95% CI) = 1.26 (1.00–1.57) for per 6 μg/m3increase in the concentration. Pneumonia was also associated with postnatal exposure to indoor renovation, adjusted OR (95% CI) = 1.30 (1.02–1.64) for new furniture and 1.30 (1.00–1.69) for redecoration. Combined exposure to outdoor high PM10and indoor renovation significantly increased the pneumonia risk. Sensitivity analysis indicated that the association was heterogeneous in different subgroups, but stronger in male and younger children.ConclusionHigh prevalence of childhood pneumonia in China may be associated with postnatal exposure to ambient particulate air pollution and house renovation.Graphical abstractDisplay OmittedHighlights•Prevalence of childhood pneumonia is very high in China but the risk factors remain unclear.•We examined the risk of long-term early-life exposure to both outdoor and indoor air pollution.•Ambient particulate air pollution was found to be associated with childhood pneumonia.•Indoor new furniture and redecoration increased the risk of childhood pneumonia.•Double exposure to outdoor air pollution and indoor renovation caused high risk of pneumonia.