Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries

Background: Evidence from developed countries suggests that fine particulate matter (≤2.5 µm [PM2.5]) contributes to childhood respiratory morbidity and mortality. However, few analyses have focused on resource-limited settings, where much of this burden occurs. We aimed to investigate the cross-sec...

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Main Authors: Daniel B. Odo, Ian A. Yang, Sagnik Dey, Melanie S. Hammer, Aaron van Donkelaar, Randall V. Martin, Guang-Hui Dong, Bo-Yi Yang, Perry Hystad, Luke D. Knibbs
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Environment International
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0160412021006449
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author Daniel B. Odo
Ian A. Yang
Sagnik Dey
Melanie S. Hammer
Aaron van Donkelaar
Randall V. Martin
Guang-Hui Dong
Bo-Yi Yang
Perry Hystad
Luke D. Knibbs
author_facet Daniel B. Odo
Ian A. Yang
Sagnik Dey
Melanie S. Hammer
Aaron van Donkelaar
Randall V. Martin
Guang-Hui Dong
Bo-Yi Yang
Perry Hystad
Luke D. Knibbs
author_sort Daniel B. Odo
collection DOAJ
description Background: Evidence from developed countries suggests that fine particulate matter (≤2.5 µm [PM2.5]) contributes to childhood respiratory morbidity and mortality. However, few analyses have focused on resource-limited settings, where much of this burden occurs. We aimed to investigate the cross-sectional associations between annual average exposure to ambient PM2.5 and acute respiratory infection (ARI) in children aged <5 years living in low- and middle-income countries (LMICs). Methods: We combined Demographic and Health Survey (DHS) data from 35 countries with gridded global estimates of annual PM2.5 mass concentrations. We analysed the association between PM2.5 and maternal-reported ARI in the two weeks preceding the survey among children aged <5 years living in 35 LMICs. We used multivariable logistic regression models that adjusted for child, maternal, household and cluster-level factors. We also fitted multi-pollutant models (adjusted for nitrogen dioxide [NO2] and surface-level ozone [O3]), among other sensitivity analyses. We assessed whether the associations between PM2.5 and ARI were modified by sex, age and place of residence. Results: The analysis comprised 573,950 children, among whom the prevalence of ARI was 22,506 (3.92%). The mean (±SD) estimated annual concentration of PM2.5 to which children were exposed was 48.2 (±31.0) µg/m3. The 5th and 95th percentiles of PM2.5 were 9.8 µg/m3 and 110.9 µg/m3, respectively. A 10 µg/m3 increase in PM2.5 was associated with greater odds of having an ARI (OR: 1.06; 95% CI: 1.05–1.07). The association between PM2.5 and ARI was robust to adjustment for NO2 and O3. We observed evidence of effect modification by sex, age and place of residence, suggesting greater effects of PM2.5 on ARI in boys, in younger children, and in children living in rural areas. Conclusions: Annual average ambient PM2.5, as an indicator for long-term exposure, was associated with greater odds of maternal-reported ARI in children aged <5 years living in 35 LMICs. Longitudinal studies in LMICs are required to corroborate our cross-sectional findings, to further elucidate the extent to which lowering PM2.5 may have a role in the global challenge of reducing ARI-related morbidity and mortality in children.
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spelling doaj.art-3602cb0ee3ae44efb565a4f5e9d25a0b2022-12-21T19:35:00ZengElsevierEnvironment International0160-41202022-01-01159107019Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countriesDaniel B. Odo0Ian A. Yang1Sagnik Dey2Melanie S. Hammer3Aaron van Donkelaar4Randall V. Martin5Guang-Hui Dong6Bo-Yi Yang7Perry Hystad8Luke D. Knibbs9School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; College of Health Sciences, Arsi University, Asela, Ethiopia; Corresponding author at: School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.Thoracic Program, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia; UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, AustraliaCentre for Atmospheric Sciences, Indian Institute of Technology Delhi, New Delhi, India; Centre of Excellence for Research on Clean Air, Indian Institute of Technology Delhi, New Delhi, IndiaDepartment of Energy, Environmental &amp; Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USADepartment of Energy, Environmental &amp; Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USADepartment of Energy, Environmental &amp; Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USAGuangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, ChinaGuangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, ChinaCollege of Public Health and Human Sciences, Corvallis, OR, USASchool of Public Health, The University of Queensland, Herston, QLD 4006, Australia; School of Public Health, The University of Sydney, Camperdown, NSW 2006, AustraliaBackground: Evidence from developed countries suggests that fine particulate matter (≤2.5 µm [PM2.5]) contributes to childhood respiratory morbidity and mortality. However, few analyses have focused on resource-limited settings, where much of this burden occurs. We aimed to investigate the cross-sectional associations between annual average exposure to ambient PM2.5 and acute respiratory infection (ARI) in children aged <5 years living in low- and middle-income countries (LMICs). Methods: We combined Demographic and Health Survey (DHS) data from 35 countries with gridded global estimates of annual PM2.5 mass concentrations. We analysed the association between PM2.5 and maternal-reported ARI in the two weeks preceding the survey among children aged <5 years living in 35 LMICs. We used multivariable logistic regression models that adjusted for child, maternal, household and cluster-level factors. We also fitted multi-pollutant models (adjusted for nitrogen dioxide [NO2] and surface-level ozone [O3]), among other sensitivity analyses. We assessed whether the associations between PM2.5 and ARI were modified by sex, age and place of residence. Results: The analysis comprised 573,950 children, among whom the prevalence of ARI was 22,506 (3.92%). The mean (±SD) estimated annual concentration of PM2.5 to which children were exposed was 48.2 (±31.0) µg/m3. The 5th and 95th percentiles of PM2.5 were 9.8 µg/m3 and 110.9 µg/m3, respectively. A 10 µg/m3 increase in PM2.5 was associated with greater odds of having an ARI (OR: 1.06; 95% CI: 1.05–1.07). The association between PM2.5 and ARI was robust to adjustment for NO2 and O3. We observed evidence of effect modification by sex, age and place of residence, suggesting greater effects of PM2.5 on ARI in boys, in younger children, and in children living in rural areas. Conclusions: Annual average ambient PM2.5, as an indicator for long-term exposure, was associated with greater odds of maternal-reported ARI in children aged <5 years living in 35 LMICs. Longitudinal studies in LMICs are required to corroborate our cross-sectional findings, to further elucidate the extent to which lowering PM2.5 may have a role in the global challenge of reducing ARI-related morbidity and mortality in children.http://www.sciencedirect.com/science/article/pii/S0160412021006449Respiratory infectionAir pollutionPM2.5ChildrenHousehold surveyDeveloping country
spellingShingle Daniel B. Odo
Ian A. Yang
Sagnik Dey
Melanie S. Hammer
Aaron van Donkelaar
Randall V. Martin
Guang-Hui Dong
Bo-Yi Yang
Perry Hystad
Luke D. Knibbs
Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
Environment International
Respiratory infection
Air pollution
PM2.5
Children
Household survey
Developing country
title Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
title_full Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
title_fullStr Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
title_full_unstemmed Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
title_short Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
title_sort ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries
topic Respiratory infection
Air pollution
PM2.5
Children
Household survey
Developing country
url http://www.sciencedirect.com/science/article/pii/S0160412021006449
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