Published ahead of print on March 11, 2005, doi:10.1164/rccm.200411-1586OC Am. J. Respir. Crit. Care Med., Volume 171, Number 11, June 2005, 1272-1278 A more recent version of this article appeared on June 1, 2005
Submitted on November 25, 2004 Air Pollution and Child Respiratory Health: a Case-crossover Study in Australia and New ZealandAdrian G Barnett1,1 School of Population Health, University of Queensland, Herston, Queensland, Australia, 2 Exposure, Epidemiology, and Risk Program, Harvard School of Public Health, Boston, MA, USA, 3 Faculty of Science, University of the Sunshine Coast, Maroochydore, Queensland, Australia * To whom correspondence should be addressed. E-mail: rsimpson{at}usc.edu.au.
Rationale. The strength of the association between outdoor air pollution and hospital admissions in children has not yet been well defined. Objectives. To estimate the impact of outdoor air pollution on respiratory morbidity in children after controlling for the confounding effects of weather, season and other pollutants. Methods. The study used data on respiratory hospital admissions in children (three age groups: less than 1 year, 1-4 years, and 5-14 years) for five cities in Australia and two in New Zealand. Time-series of daily numbers of hospital admissions were analyzed using the case-crossover method; the results from cities were combined using a random effects meta-analysis. Measurements and Main Results. Significant increases across the cities were observed for hospital admissions in children for pneumonia and acute bronchitis (0, 1-4 years), respiratory disease (0, 1-4 years, 5-14 years) and asthma (5-14 years). These increases were found for particles (PM2.5, PM10, nephelometry), NO2, and SO2, . The largest association found was a 6.0% increase in asthma admissions (5-14 years) in relation to a 5.1 ppb increase in 24-hour NO2. Conclusions. This study found strong and consistent associations between outdoor air pollution and short-term increases in childhood hospital admissions. A number of different pollutants showed significant associations and these were distinct from any temperature (warm or cool) effects. Key words: air pollutants, meta-analysis, respiration disorders, Australasia
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