The short-term association between environmental variables and daily pediatric asthma patient visits in Hangzhou, China: A time-series study

This is the authors' abstract. We don't add key points for this paper.

Background To date, a large number of studies have shown correlations between environmental variables and pediatric asthma in short-term lag time. However, their results are inconsistent. Therefore, we aimed to evaluate the short-term impact of environmental variables on daily pediatric asthma patients' visits (DPAPV) in Hangzhou, China, and find the most important risk factor. Methods Generalized additive distribution lag non-linear model (GAM-DLNM) was applied to explore the effect of environmental variables on DPAPV in single- and multi-variable models in Hangzhou, China from 2014 to 2021. Then, risk factors of pediatric asthma were selected (p < 0.05 both in single- and multi-variable models) and used weighted quantile sum (WQS) regression model to evaluate their relative importance. Results There were 313,296 pediatric asthma patient records between 2014 and 2021. Both in single- and multi-variable models, PM 2.5 , PM 10 , and NO 2 exhibited significant positive correlations in short-term lag time and these correlations reached their maximum in lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), lag day 2 (RR = 1.00, 95%CI:1.00 to 1.01), and lag day 3 (RR = 1.04, 95%CI:1.02 to1.05), respectively. The WQS index showed that NO 2 had the greatest relative importance (weight over 70 %). The relative importance of NO 2 increased with time passing. Males were more susceptible to the adverse effects of NO 2 . Conclusion PM 2.5 , PM 10 , and NO 2 had significant adverse effects on pediatric asthma. Among them, NO 2 presented the greatest and most important adverse effect on the disease. Therefore, parents could give priority to paying attention to NO 2 to control children's asthma.