Short-term traffic-related gaseous pollutant exposure is associated with childhood bronchopneumonia hospitalization: a 10-year time-series study from Guangzhou, China
Jul 2026· Frontiers in Public Health· Vol 14· 0 citations· 35 references
Medicine
TL;DR
Findings provide the first long-term evidence from Guangzhou that short-term NO2 and SO2 exposure is positively associated with childhood bronchopneumonia hospitalization, with older children and boys being the susceptible subgroups.
Abstract
Short-term exposure to traffic-related gaseous pollutants [nitrogen dioxide (NO2) and sulfur dioxide (SO2)] may increase childhood bronchopneumonia risk, but evidence from megacities with high pollution levels remains limited. This study aimed to evaluate the association between short-term exposure to NO2 and SO2 and pediatric bronchopneumonia hospitalization in Guangzhou. We collected all pediatric inpatient records with a primary discharge diagnosis of bronchopneumonia (International Classification of Diseases, Tenth Revision: J18) among children aged 0 to 14 years from a tertiary hospital in the Huadu District, between 1 January 2014 and 31 December 2023. Daily air pollutant and meteorological data were integrated with admission records and analyzed using a generalized additive model with quasi-Poisson distribution. A total of 20,623 hospitalisations were included, of which 60.6% were male and 68.4% were aged <6 years. Both NO2 and SO2 were positively associated with bronchopneumonia hospitalization. Per 5 μg/m3 increase in pollutant concentration, for single-day exposure, the peak excess risks (ERs) occurred at lag 4 (NO2: 2.74% [95% confidence interval (CI): 1.73–3.75]; SO2: 8.81% [95% CI: 4.94–12.82]); For the 0-7 day moving average, the ERs increased to 6.83% (95% CI 4.93–8.77) for NO2 and 17.21% (95% CI 10.18–24.70) for SO2. Children aged 6–14 years and boys showed consistently higher susceptibility. These findings provide the first long-term evidence from Guangzhou that short-term NO2 and SO2 exposure is positively associated with childhood bronchopneumonia hospitalization, with older children and boys being the susceptible subgroups. Public health authorities should consider developing targeted air pollution alert thresholds and intervention strategies for school-aged children and boys.
Short-term exposure to PM2.5, PM10, SO2, NO2, and CO was associated with increased AECOPD hospitalization risk, with nonlinear, lagged, and cumulative effects, and older adults and females may be more susceptible to ambient air pollution.
Huixia Shi, Jiajun Li, Bo-Yan Li et al.· Medicine· 0 citations
This study aims to quantify the short-term association between ambient air pollutants and outpatient visits for conjunctivitis using empirical data. Methods: This study collected daily outpatient visits for conjunctivitis in Jiayuguan City from January 1, 2023 to December 31, 2024, as well as meteorological and air pollutant data during the same period. We used a quasi-Poisson generalized linear regression model that incorporates a distributed lag nonlinear model to analyze the nonlinear relationship and lag effect between pollutant exposure and the risk of outpatient visits for conjunctivitis, and conducted stratified analysis by gender, age and season to identify susceptible populations. Results: A total of 14,598 cases of conjunctivitis were included during the study. The results showed that particulate matter (PM
2.5
and PM
10
) was not statistically significantly associated with outpatients for conjunctivitis, and the exposure-response curve showed a downward trend. Conversely, gaseous pollutants (NO
2
and CO) showed a significant positive linear correlation with outpatients for conjunctivitis, with the effect being stronger in the cold season. NO
2
was significant at lag1-3, lag5 days and lag02–07 days, with each 10 µg/m
3
increase corresponding to an RR of 1.126 (95% CI 1.050, 1.208), corresponding to a 12.60% increase in patient visits. CO had the strongest effect at lag07 days (RR = 1.836, 95% CI 1.126, 2.991). Furthermore, NO
2
primarily increases conjunctivitis visits in women and children (0–14 years), while CO exposure is significantly associated with conjunctivitis visits in men and older adults (≥ 65 years). Conclusions: In this arid, industrial city in Northwest China, gaseous pollutants (rather than particulate matter) are the key environmental factor driving the increase in conjunctivitis outpatient visits. This study reveals the differentiated effects of specific pollutants on populations with different demographic characteristics, highlighting the public health significance of strengthening ocular surface health protection for specific vulnerable subgroups during the cold season.
Yanan Zhang, Guorui Song, Bo Zheng et al.· Aerosol and Air Quality Rese...· 0 citations
PM2.5, PM10, NO2, and CO exposures were associated with COPD hospitalization in Kashi, precautionary measures should be taken with a focus on vulnerable subgroups, to control hospitalization for COPD associated with air pollutants.
Li Li, Ayiguli Alimu, Jingran Xu et al.· International Journal of COP...· 0 citations
This study examines the long-term associations between ambient air pollutants and the burden of major respiratory and infectious diseases in this geographically sensitive region. A retrospective analysis was conducted using ICD-10-coded hospital records of patients diagnosed with asthma, chronic obstructive pulmonary disease (COPD), bronchitis, and tuberculosis from January 2020 to June 2026. These data were integrated with in situ air quality measurements, including PM10, PM2.5, and SO2, as well as satellite-derived Aerosol Optical Depth (AOD) from MODIS. Disease incidence was stratified by year, sex, and age groups (0–85+ years) to assess demographic susceptibility patterns. Respiratory diseases constituted a substantial public health burden over the study period. Asthma showed a marked female predominance (≈29,700 females vs. ≈16,000 males) and a bimodal age distribution with peaks in early childhood (0–5 years) and mid-adulthood (35–50 years). COPD was predominantly observed in males (≈8300 males vs. ≈5500 females), with a higher median age range (≈67–70 years). Bronchitis exhibited a similar bimodal pattern, disproportionately affecting both pediatric and elderly populations, while overall case numbers declined over time. Tuberculosis incidence was approximately threefold higher in males than females, with notable age-related divergence, affecting younger females (≈30–32 years) and middle-aged males (≈42–45 years). The findings suggest a spatial–temporal correspondence between elevated pollutant concentrations and respiratory disease prevalence in the Iğdır Basin. The observed sex- and age-specific disparities underscore the potential value of region-specific environmental health strategies, strengthened air quality management, and continuous epidemiological surveillance in enclosed basin environments.
Melahat Batu Ağırkaya, Fatma Şencan, Mehmet Ali Çelik· Pollutants· 0 citations
Short-term absolute changes in ambient air pollution levels may result in disease events such as depression, whereas evidence from large-scale epidemiological studies has been insufficient. A time-stratified case-crossover study was performed to investigate the associations between air pollution increases between neighboring days (APINs, generated as the differences in absolute air pollution concentrations on the current days minus those on the previous days) and morbidity risks of depression based on hospital admission and outpatient visit data from 239 Chinese cities of prefecture-level or above during 2013-2017. Daily absolute concentrations of particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (8 h O3) were obtained, and conditional logistic regression models were used to evaluate the associations between absolute concentrations and APINs of major air pollutants with morbidity risks of depression. A total of 330,610 hospital admissions and 3,726,390 outpatient visits for depression were included. Per interquartile range (IQR) increase in APINs of major air pollutants at lag 0-3 were associated with increases ranging from 0.59% (0.06%, 1.13%) (8 h O3) to 1.66% (1.09%, 2.22%) (NO2) in hospital admissions for depression; and with increases ranging from 0.42% (0.15%, 0.68%) (8 h O3) to 0.85% (0.56%, 1.14%) (NO2) in outpatient visits for depression, which were robust to adjustments for absolute concentrations of major air pollutants (with the exception of 8 h O3). This study provides novel evidence that short-term absolute increases in air pollution levels are associated with elevated risks of depression, which is worth consideration in future disease prevention practices.
Yating Ma, Chenlu Yang, Lijun Bai et al.· Ecotoxicology and Environmen...· 0 citations
Stroke is a leading cause of death and disability worldwide. Exposure to ambient air pollutants and the risk of stroke have been reported in many studies, but the results vary greatly among different regions. This study aims to investigate the association between short-term exposure to air pollution and the admission of total stroke and its subtypes in the Luohu District, Shenzhen. A time-stratified case-crossover study was conducted among 21,973 newly diagnosed stroke cases in Luohu, Shenzhen from 2014 to 2022. Residential exposure to air pollution was assessed using validated grid datasets. A distributed lag model (DLM) and conditional logistic regression model were implemented to evaluate the relationship between ambient air pollution and the admission of stroke and its subtypes. We found that a 10 µg/m3 increase in exposure to NO2 and SO2 was positively associated with a 2.73% increase (95% confidence interval [CI]: 2.21%, 3.25%) and a 24.89% increase (20.87%, 29.06%) in the odds of total stroke admission, respectively. Statistical significance has also been found in subtypes. Stronger associations were observed in females (SO2), the elderly (NO2 and SO2), and the cold season (NO2 and SO2). Our findings indicate that exposure to NO2 and SO2 exacerbates the risk of stroke admission, especially in the elderly, females, and the cold season.
