Short-term association between ambient air pollution and childhood non-allergic rhinitis: A time-series study at a National Children's Regional Medical Center, in Hefei, China, from 2015 to 2021

Wei Cui; Hongxia Gao; Liran Zhu; Yuanyuan Xu; Haipeng Liu

doi:10.1016/j.ecoenv.2024.117590

Short-term association between ambient air pollution and childhood non-allergic rhinitis: A time-series study at a National Children's Regional Medical Center, in Hefei, China, from 2015 to 2021

Ecotoxicol Environ Saf. 2024 Dec 24:290:117590. doi: 10.1016/j.ecoenv.2024.117590. Online ahead of print.

Authors

Wei Cui¹, Hongxia Gao², Liran Zhu¹, Yuanyuan Xu³, Haipeng Liu⁴

Affiliations

¹ Department of Scientific Research, Anhui Provincial Children's Hospital (Anhui Hospital, Children's Hospital of Fudan University), Hefei, Anhui 230051,China; Anhui Institute of Pediatric Research, Hefei, Anhui 230051, China; Children's Medical Center of Anhui Medical University, Hefei, Anhui 230032, China.
² Department of Gynecology and Obstetric, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230000, China.
³ Children's Medical Center of Anhui Medical University, Hefei, Anhui 230032, China; Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital (Anhui Hospital of Children's Hospital of Fudan University), Hefei, Anhui 230051, China.
⁴ Department of Scientific Research, Anhui Provincial Children's Hospital (Anhui Hospital, Children's Hospital of Fudan University), Hefei, Anhui 230051,China; Anhui Institute of Pediatric Research, Hefei, Anhui 230051, China; Children's Medical Center of Anhui Medical University, Hefei, Anhui 230032, China. Electronic address: hpscience@126.com.

PMID: 39721429
DOI: 10.1016/j.ecoenv.2024.117590

Abstract

The relationship between air pollution exposure and non-allergic rhinitis (NAR) risk in children is underexplored and uncertain. Therefore, the impact of numerous air pollutants on the incidence of NAR in a Chinese pediatric population were investigated. Data on daily outpatient visits for NAR among children aged 0-18 years from 2015 to 2021 were obtained from Anhui Provincial Children's Hospital. A quasi-Poisson generalized linear regression model combined with a distributed lag nonlinear model was applied to evaluate the association between air pollution and outpatient visits for childhood NAR. A total of 38233 NAR outpatients were included and a positive association and cumulative effects between air pollution and childhood NAR were observed. The relative risks (RRs) and 95 % confidence intervals (95 % CIs) for childhood NAR at the 75th percentile of NO₂, SO₂, PM₁₀, PM_2.5, O₃, and CO against their minimum concentrations were 1.157 (95 % CI: 1.089, 1.23), 1.078 (1.005, 1.157), 1.168 (1.089, 1.252), 1.076 (1.02, 1.136), 1.033 (0.961, 1.11) and 1.07 (1.01, 1.134), respectively. The cumulative effects of the air pollutants were pronounced, which was much higher than each single effects. Furthermore, the risk estimates for childhood NAR during the cold season were higher than those in the warm season. Lastly, boys and school children were found to be more vulnerable to air pollutants than girls and preschool children. All these findings suggest that air pollutants have adverse effects on childhood NAR, even at levels below those recommended by the air quality guidelines. Our study results highlight the significance of paying attention to the effects of air pollutants to prevent NAR occurrence, particularly in boys and school children and during the cold season. Therefore, stronger control measures to mitigate air pollution must be implemented to decrease NAR incidence in the pediatric population.

Keywords: Air pollution; Cold season; Cumulative effect; Non-allergic rhinitis.