Associations of ambient particulate matter and ozone with pediatric pneumonia hospitalizations in Baotou urban districts
- VernacularTitle:包头市城区大气颗粒物和臭氧与儿童肺炎住院的关联
- Author:
Jing LU
1
;
Xiaodong FENG
1
;
Jing CHENG
1
;
Zhihong ZHANG
1
;
Yue JI
2
Author Information
- Publication Type:Investigation
- Keywords: particulate matter; ozone; pediatric pneumonia; hospitalization; season; time-series analysis
- From: Journal of Environmental and Occupational Medicine 2026;43(9):1110-1115
- CountryChina
- Language:Chinese
- Abstract: Background Air pollution poses a significant threat to children's respiratory health. Baotou, a resource-dependent industrial city in northern China dominated by coal, power generation, and steel industries, has limited evidence on the associations of inhalable particulate matter (PM10), fine particulate matter (PM2.5), and ozone (O3) with pediatric pneumonia hospitalizations, particularly with respect to season-specific lagged effects. Objective To evaluate the associations of PM10, PM2.5, and O3 with pediactric pneumonia hospitalizations and to examine seasonal variations in these associations in the urban districts of Baotou. Methods A time-series study was conducted using daily data on air pollutant concentrations, meteorological factors, and pediatric pneumonia hospitalizations in Baotou from 2017 to 2022. Generalized additive models were applied to examine single-pollutant associations. Cumulative lag models were fitted to assess delayed and cumulative effects, and season-stratified models were constructed to identify season-specific risks. Two-pollutant and multi-pollutant models were further developed to evaluate the robustness of the observed associations. Results The annual mean concentrations of PM2.5 and PM10 were 38.62 μg·m−3 and 85.44 μg·m−3, respectively.PM10 and O3 were the most frequent primary pollutants, accounting for 32.6% and 30.7% of polluted days, respectively. Significant positive associations with lag effects were observed between air pollutants and pediatric pneumonia hospitalizations. In the full-year model, PM10 showed the strongest association at lag 3 (ER=0.77%, 95%CI: 0.50%, 1.04%), whereas PM2.5 showed the strongest association at lag 1 (ER=1.85%, 95%CI: 1.23%, 2.48%). Seasonal stratification analyses revealed significant associations for PM2.5 in both the cold season (lag 1, ER=1.57%, 95%CI: 0.83%, 2.31%) and the warm season (lag 7, ER=1.84%, 95%CI: 0.35%, 3.35%). PM10 showed a significant association at lag 7 in the warm season (ER=0.70%, 95%CI: 0.27%, 1.13%). O3 exhibited significant acute effects only in the warm season, with same-day exposure (lag 0) associated with an ER of 3.79% (95%CI: 1.92%, 5.69%). The estimated risk contribution ranking was PM2.5 > PM10 for the full year and the cold season, and O3 > PM2.5 > PM10 for the warm season. Cumulative lag analysis revealed that PM10 and PM2.5 exhibited the strongest cumulative associations at lag07 in the full-year and cold-season models, with ERs of 2.20% (95%CI: 1.68%, 2.72%) and 4.20% (95%CI: 3.01%, 5.40%), respectively, and the associations intensified as the lag period extended. In contrast, O3 in the warm season showed the strongest cumulative association at lag02, with an ER of 5.37% (95%CI: 3.13%, 7.66%), followed by a rapid decline. O3 in the cold season showed a significant cumulative association at lag07, with an ER of 5.12% (95%CI: 0.00%, 10.49%). In two-pollutant and multi-pollutant models, the associations of PM10 and O3 remained stable after adjustment for other pollutants. Conclusion From 2017 to 2022, ambient particulate matter and ozone are significantly associated with pediatric pneumonia hospitalizations in the urban districts of Baotou, with evident lagged effects and seasonal variations. Differentiated prevention strategies should be developed according to seasonal pollutant profiles, with priority given to PM2.5 control in the cold season and O3 control in the warm season.
