Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children

Numerous studies have demonstrated that exposure to ambient ozone (O<sub>3</sub>) could have adverse effects on children’s respiratory health. However, previous studies mainly focused on asthma and wheezing. Evidence for allergic rhinitis and bronchitic symptoms (e.g., persistent cough a...

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Main Authors: Pei-En Zhou, Zhengmin (Min) Qian, Stephen Edward McMillin, Michael G. Vaughn, Zhong-Yue Xie, Yu-Jie Xu, Li-Zi Lin, Li-Wen Hu, Bo-Yi Yang, Xiao-Wen Zeng, Wang-Jian Zhang, Ru-Qing Liu, Gongbo Chen, Guang-Hui Dong
Format: Article
Language:English
Published: MDPI AG 2021-09-01
Series:Toxics
Subjects:
Online Access:https://www.mdpi.com/2305-6304/9/9/221
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author Pei-En Zhou
Zhengmin (Min) Qian
Stephen Edward McMillin
Michael G. Vaughn
Zhong-Yue Xie
Yu-Jie Xu
Li-Zi Lin
Li-Wen Hu
Bo-Yi Yang
Xiao-Wen Zeng
Wang-Jian Zhang
Ru-Qing Liu
Gongbo Chen
Guang-Hui Dong
author_facet Pei-En Zhou
Zhengmin (Min) Qian
Stephen Edward McMillin
Michael G. Vaughn
Zhong-Yue Xie
Yu-Jie Xu
Li-Zi Lin
Li-Wen Hu
Bo-Yi Yang
Xiao-Wen Zeng
Wang-Jian Zhang
Ru-Qing Liu
Gongbo Chen
Guang-Hui Dong
author_sort Pei-En Zhou
collection DOAJ
description Numerous studies have demonstrated that exposure to ambient ozone (O<sub>3</sub>) could have adverse effects on children’s respiratory health. However, previous studies mainly focused on asthma and wheezing. Evidence for allergic rhinitis and bronchitic symptoms (e.g., persistent cough and phlegm) associated with O<sub>3</sub> is limited, and results from existing studies are inconsistent. This study included a total of 59,754 children from the seven northeastern cities study (SNEC), who were aged 2 to 17 years and from 94 kindergarten, elementary and middle schools. Information on doctor-diagnosed allergic rhinitis (AR), persistent cough, and persistent phlegm was collected during 2012–2013 using a standardized questionnaire developed by the American Thoracic Society (ATS). Information for potential confounders was also collected via questionnaire. Individuals’ exposure to ambient ozone (O<sub>3</sub>) during the four years before the investigation was estimated using a satellite-based random forest model. A higher level of O<sub>3</sub> was significantly associated with increased risk of AR and bronchitic symptoms. After controlling for potential confounders, the OR (95% CI) were 1.13 (1.07–1.18), 1.10 (1.06–1.16), and 1.12 (1.05–1.20) for AR, persistent cough, and persistent phlegm, respectively, associated with each interquartile range (IQR) rise in O<sub>3</sub> concentration. Interaction analyses showed stronger adverse effects of O<sub>3</sub> on AR in children aged 7–17 years than those aged 2–6 years, while the adverse association of O<sub>3</sub> with cough was more prominent in females and children aged 7–12 years than in males and children aged 2–6 and 13–17 years. This study showed that long-term exposure to ambient O<sub>3</sub> was significantly associated with higher risk of AR and bronchitic symptoms in children, and the association varies across age and gender. Our findings contribute additional evidence for the importance of controlling O<sub>3</sub> pollution and protecting children from O<sub>3</sub> exposure.
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spelling doaj.art-a6c837eeee43400bad6ff2fa077e43332023-11-22T15:30:30ZengMDPI AGToxics2305-63042021-09-019922110.3390/toxics9090221Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese ChildrenPei-En Zhou0Zhengmin (Min) Qian1Stephen Edward McMillin2Michael G. Vaughn3Zhong-Yue Xie4Yu-Jie Xu5Li-Zi Lin6Li-Wen Hu7Bo-Yi Yang8Xiao-Wen Zeng9Wang-Jian Zhang10Ru-Qing Liu11Gongbo Chen12Guang-Hui Dong13Guangdong 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, ChinaDepartment of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USASchool of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USASchool of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, 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, 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, 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, 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, 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, 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, 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, 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, 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, ChinaNumerous studies have demonstrated that exposure to ambient ozone (O<sub>3</sub>) could have adverse effects on children’s respiratory health. However, previous studies mainly focused on asthma and wheezing. Evidence for allergic rhinitis and bronchitic symptoms (e.g., persistent cough and phlegm) associated with O<sub>3</sub> is limited, and results from existing studies are inconsistent. This study included a total of 59,754 children from the seven northeastern cities study (SNEC), who were aged 2 to 17 years and from 94 kindergarten, elementary and middle schools. Information on doctor-diagnosed allergic rhinitis (AR), persistent cough, and persistent phlegm was collected during 2012–2013 using a standardized questionnaire developed by the American Thoracic Society (ATS). Information for potential confounders was also collected via questionnaire. Individuals’ exposure to ambient ozone (O<sub>3</sub>) during the four years before the investigation was estimated using a satellite-based random forest model. A higher level of O<sub>3</sub> was significantly associated with increased risk of AR and bronchitic symptoms. After controlling for potential confounders, the OR (95% CI) were 1.13 (1.07–1.18), 1.10 (1.06–1.16), and 1.12 (1.05–1.20) for AR, persistent cough, and persistent phlegm, respectively, associated with each interquartile range (IQR) rise in O<sub>3</sub> concentration. Interaction analyses showed stronger adverse effects of O<sub>3</sub> on AR in children aged 7–17 years than those aged 2–6 years, while the adverse association of O<sub>3</sub> with cough was more prominent in females and children aged 7–12 years than in males and children aged 2–6 and 13–17 years. This study showed that long-term exposure to ambient O<sub>3</sub> was significantly associated with higher risk of AR and bronchitic symptoms in children, and the association varies across age and gender. Our findings contribute additional evidence for the importance of controlling O<sub>3</sub> pollution and protecting children from O<sub>3</sub> exposure.https://www.mdpi.com/2305-6304/9/9/221allergic rhinitisozonechildren and adolescentChina
spellingShingle Pei-En Zhou
Zhengmin (Min) Qian
Stephen Edward McMillin
Michael G. Vaughn
Zhong-Yue Xie
Yu-Jie Xu
Li-Zi Lin
Li-Wen Hu
Bo-Yi Yang
Xiao-Wen Zeng
Wang-Jian Zhang
Ru-Qing Liu
Gongbo Chen
Guang-Hui Dong
Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
Toxics
allergic rhinitis
ozone
children and adolescent
China
title Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
title_full Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
title_fullStr Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
title_full_unstemmed Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
title_short Relationships between Long-Term Ozone Exposure and Allergic Rhinitis and Bronchitic Symptoms in Chinese Children
title_sort relationships between long term ozone exposure and allergic rhinitis and bronchitic symptoms in chinese children
topic allergic rhinitis
ozone
children and adolescent
China
url https://www.mdpi.com/2305-6304/9/9/221
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