Air pollution and children's asthma-related emergency hospital visits in southeastern France

Julie Mazenq (1) , J.C. Dubus (1) , Jean Gaudart (2) , Denis André Charpin (3) , A. Nougairede (4, 5) , Viudes Gilles (6) , Guilhem Noel (7, 6)

1 Pédiatrie et oncologie pédiatrique [Hôpital de la Timone - APHM]
2 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
3 Hôpital Nord [CHU - APHM]
4 EPV - Emergence des Pathologies Virales
5 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
6 Regional Emergencies Observatory, Provence-Alpes-Cote d'Azur region (ORU PACA), Hyères, France.
7 Médecine Infantile [Hôpital Nord - APMH]

Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM10 and PM2.5, meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. CONCLUSION: PM10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

Mots clés: Air; Asthma; Children; Environment; pollution

Domaines: Systèmes dynamiques [math.DS]; Probabilités [math.PR]; Applications [stat.AP]; Méthodologie [stat.ME]; Statistiques [math.ST]; Environnement et Société; Santé; Maladies infectieuses; Maladies émergentes; Parasitologie; Santé publique et épidémiologie

Julie Mazenq, J.C. Dubus, Jean Gaudart, Denis André Charpin, A. Nougairede, et al.. Air pollution and children's asthma-related emergency hospital visits in southeastern France. European Journal of Pediatrics, 2017, 176 (6), pp.705-711. ⟨10.1007/s00431-017-2900-5⟩. ⟨hal-01527561⟩