Construction of an air quality health index for pediatric respiratory disease in Shijiazhuang, China

Objective To investigate the effects of air pollution on pediatric respiratory diseases in Shijiazhuang, China, and to construct an air quality health index (AQHI) for the incidence risk of pediatric respiratory diseases in Shijiazhuang.

Methods The data on ambient pollutants, meteorological factors and outpatient visits for respiratory diseases were collected in Children's Hospital of Hebei Province from 2017 to 2021. A generalized additive model was conducted to quantitatively analyze the exposure-response relationship between pollutants and the number of pediatric outpatient visits for the incidence risk of respiratory diseases. The AQHI was constructed based on the excess risk of outpatient visits, and the effects of AQHI and air quality index (AQI) on the incidence risk of respiratory diseases in children were compared.

Results Every 10 μg/m³ increment in the mass concentration of PM_2.5, SO₂ and NO₂ was associated with 0.23%(95%CI: 0.06%, 0.41%), 2.10%(95%CI: 0.95%, 3.27%), and 1.18%(95%CI: 0.61%, 1.75%) increase in the incidence risk of pediatric respiratory diseases, respectively. Ozone had no significant effect on the incidence risk of pediatric respiratory diseases(P>0.05). Sex-stratified analysis revealed that PM_2.5 had greater effects on girls, while SO₂ and NO₂ had greater effects on boys. Age-stratified analysis showed that SO₂ and NO₂ had greater effects on children aged 7-14 years. After comprehensive analysis, compared with AQI, AQHI which was constructed including PM_2.5, SO₂ and NO₂ could better describe medical visits for respiratory diseases in children.

Conclusion PM_2.5, SO₂ and NO₂ have impacts on the incidence risk of pediatric respiratory diseases in Shijiazhuang. The AQHI for pediatric respiratory diseases can well predict the effects of air pollution on the incidence risk of pediatric respiratory diseases in Shijiazhuang.