The impact of ambient air pollutants on childhood respiratory system disease and the resulting disease burden: a time-series study

Int Arch Occup Environ Health. 2023 Oct;96(8):1087-1100. doi: 10.1007/s00420-023-01991-8. Epub 2023 Jun 20.


Purpose: The effects of air pollution on human health have long been a hot topic of research. For respiratory diseases, a large number of studies have proved that air pollution is one of the main causes. The purpose of this study was to investigate the risk of hospitalization of children with respiratory system diseases (CRSD) caused by six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) in Hefei City, and further calculate the disease burden.

Method: In the first stage, the generalized additive models were combined with the distributed lag non-linear models to evaluate the impact of air pollution on the inpatients for CRSD in Hefei. In the second stage, this study used the cost-of-illness approach to calculate the attributable number of hospitalizations and the extra disease burden.

Result: Overall, all the six kinds of pollutants had the strongest effects on CRSD inpatients within lag10 days. SO2 and CO caused the highest and lowest harm, respectively, and the RR values were SO2 (lag0-5): 1.1 20 (1.053, 1.191), and CO (lag0-6): 1.002 (1.001, 1.003). During the study period (January 1, 2014 to December 30, 2020), the 7-year cumulative burden of disease was 36.19 million CNY under the WHO air pollution standards.

Conclusion: In general, we found that six air pollutants were risk factors for CRSD in Hefei City, and create a huge burden of disease.

Keywords: Air pollutants; Children respiratory system diseases; Cost of disease method; Disease burden; Hospitalization risk; Time-series study analysis.

MeSH terms

  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Child
  • China
  • Environmental Pollutants*
  • Humans
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Respiratory Tract Diseases* / epidemiology


  • Air Pollutants
  • Environmental Pollutants
  • Particulate Matter

Supplementary concepts

  • Night blindness, congenital stationary