Preliminary investigation of the association between air pollution exposure and childhood asthma hospitalizations from 2015 to 2018 in East China

Yuling Bao¹Jiawei Wang²Hui Huang³Zhe Sun³Mingyan Xue³Zilong Bian³Rui Jin^4*Qian Wu^3*

• ¹Nanjing Children's Hospital, Nanjing, Jiangsu Province, China
• ²Nankai University, Tianjin, China
• ³Nanjing Medical University, Nanjing, Jiangsu Province, China
• ⁴First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China

This study investigated whether air pollution exposure remains a significant factor contributing to childhood asthma in China. Short-term exposure to air pollutants was assessed using daily average concentrations of pollutants at current and lag intervals (0-6 days) from 2015 to 2018. Long-term individual exposure in 2016 was estimated using land-use regression models. The effects of short-term and long-term exposure on childhood asthma hospitalizations were evaluated using generalized additive models and multiple time-dependent Cox regression models, respectively. Hospitalizations for childhood asthma typically peaked in late spring and fall, with a higher prevalence of wheezing or asthma in males compared with that in females. Hospital admissions were most frequent among children aged 0-3 years. However, no significantly positive associations were observed between short- or long-term air pollutant exposure and daily childhood asthma hospitalizations using the applied statistical models at the levels of air pollution exposure measured during the study period. Variability in air pollution exposure did not relate to variability in hospitalizations of children with asthma in this study. Instead, asthma onset exhibited unique seasonal and demographic patterns.