Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China

Zar, H. J. & Ferkol, T. W. The global burden of respiratory disease—impact on child health. Pediatric pulmonology 49, 430–434 (2014).
World Health Organization. Pneumonia in children. (2020).
Troeger, C. et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet infectious diseases 18, 1191–1210 (2018).
Google Scholar
Walker, C. L. F. et al. Global burden of childhood pneumonia and diarrhoea. The Lancet 381, 1405–1416 (2013).
Google Scholar
Sheffield, P. E. & Landrigan, P. J. Global climate change and children’s health: threats and strategies for prevention. Environmental health perspectives 119, 291–298 (2011).
Google Scholar
Burkart, K. G. et al. Estimating the cause-specific relative risks of non-optimal temperature on daily mortality: a two-part modelling approach applied to the Global Burden of Disease Study. The Lancet 398, 685–697 (2021).
Google Scholar
Achebak, H., Devolder, D., Ingole, V. & Ballester, J. Reversal of the seasonality of temperature-attributable mortality from respiratory diseases in Spain. Nature communications 11, 2457 (2020).
Google Scholar
D’Amato, M. et al. The impact of cold on the respiratory tract and its consequences to respiratory health. Clinical and translational allergy 8, 1–8 (2018).
Google Scholar
Zhang, W., Ruan, Y., Ling, J. & Wang, L. A study of the correlation between meteorological factors and hospitalization for acute lower respiratory infections in children. BMC Public Health 24, 3135 (2024).
Google Scholar
Konstantinoudis, G. et al. Ambient heat exposure and COPD hospitalisations in England: a nationwide case-crossover study during 2007–2018. Thorax 77, 1098–1104 (2022).
Google Scholar
Wu, Y. et al. Short-term exposure to extreme temperature and outpatient visits for respiratory diseases among children in the northern city of China: a time-series study. BMC Public Health 24, 341 (2024).
Google Scholar
Hansel, N. N., McCormack, M. C. & Kim, V. The effects of air pollution and temperature on COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease 13, 372–379 (2016).
Google Scholar
Altman, M. C. et al. Associations between outdoor air pollutants and non-viral asthma exacerbations and airway inflammatory responses in children and adolescents living in urban areas in the USA: a retrospective secondary analysis. The Lancet Planetary Health 7, e33–e44 (2023).
Google Scholar
Wang, X. et al. Ambient particulate matter (PM1, PM2.5, PM10) and childhood pneumonia: the smaller particle, the greater short-term impact? Science of The Total Environment 772, 145509 (2021).
Google Scholar
Lu, C. et al. Effects of intrauterine and post-natal exposure to air pollution on children’s pneumonia: key roles in different particulate matters exposure during critical time windows. Journal of Hazardous Materials 457, 131837 (2023).
Google Scholar
Lu, C. et al. Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma. Environment International 167, 107456 (2022).
Google Scholar
Gouveia, N. et al. Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities. Environmental Pollution 232, 385–391 (2018).
Google Scholar
Leung, S. Y. et al. Short-term association among meteorological variation, outdoor air pollution and acute bronchiolitis in children in a subtropical setting. Thorax 76, 360–369 (2021).
Google Scholar
Jadhav, S. P. et al. Introduction to lung diseases. Targeting cellular Signalling pathways in lung diseases 1–25 (2021).
Gasparrini, A. et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. The lancet 386, 369–375 (2015).
Google Scholar
Habre, R. et al. The effects of PM2.5 and its components from indoor and outdoor sources on cough and wheeze symptoms in asthmatic children. Journal of exposure science environmental epidemiology 24, 380–387 (2014).
Google Scholar
Li, Y. et al. Short-term PM2. 5 exposure induces transient lung injury and repair. Journal of Hazardous Materials 459, 132227 (2023).
Google Scholar
Yang, M. et al. Is PM1 similar to PM2.5? A new insight into the association of PM1 and PM2.5 with children’s lung function. Environment international 145, 106092 (2020).
Google Scholar
Schraufnagel, D. E. The health effects of ultrafine particles. Experimental molecular medicine 52, 311–317 (2020).
Google Scholar
Perera, F. & Nadeau, K. Climate change, fossil-fuel pollution, and children’s health. New England Journal of Medicine 386, 2303–2314 (2022).
Google Scholar
Helldén, D. et al. Climate change and child health: a scoping review and an expanded conceptual framework. The Lancet Planetary Health 5, e164–e175 (2021).
Google Scholar
World Health Organization. How school systems can improve health and well-being. Topic brief: physical activity (2023).
Cattan, S., Kamhöfer, D. A., Karlsson, M. & Nilsson, T. The long-term effects of student absence: Evidence from Sweden. The Economic Journal 133, 888–903 (2023).
Google Scholar
Mahapatra, B., Walia, M., Avis, W. R. & Saggurti, N. Effect of exposure to PM10 on child health: evidence based on a large-scale survey from 184 cities in India. BMJ Global Health 5, e002597 (2020).
Google Scholar
Southerland, V. A. et al. Global urban temporal trends in fine particulate matter (PM2.5) and attributable health burdens: estimates from global datasets. The Lancet Planetary Health 6, e139–e146 (2022).
Google Scholar
Reyes-Garcia, J., Montano, L. M., Carbajal-Garcia, A. & Wang, Y.-X. In Lung Inflammation in Health and Disease, Volume II 259-321 (Springer, 2021).
Ekpruke, C. D. & Silveyra, P. Sex differences in airway remodeling and inflammation: clinical and biological factors. Frontiers in Allergy 3, 875295 (2022).
Google Scholar
Silveyra, P., Al Housseiny, H. & Rebuli, M. E. Sex and gender differences in the susceptibility to environmental exposures. Sex-based differences in lung physiology 251–290 (2021).
Verthelyi, D. Sex hormones as immunomodulators in health and disease. International immunopharmacology 1, 983–993 (2001).
Google Scholar
Lang, T. J. Estrogen as an immunomodulator. Clinical immunology 113, 224–230 (2004).
Google Scholar
Nair, H. et al. Common childhood infections and gender inequalities: a systematic review (2015).
Hesketh, T., Ding, Q. J. & Tomkins, A. M. Health and health care-seeking behavior of adolescents in urban and rural China. Journal of adolescent health 33, 271–274 (2003).
Google Scholar
Liu, T. et al. Urban-rural disparity of the short-term association of PM2.5 with mortality and its attributable burden. The Innovation 2 (2021).
Mendoza, D. L. et al. Impact of low-level fine particulate matter and ozone exposure on absences in K-12 students and economic consequences. Environmental Research Letters 15, 114052 (2020).
Google Scholar
Bener, A., Kamal, M. & Shanks, N. J. Impact of asthma and air pollution on school attendance of primary school children: are they at increased risk of school absenteeism? Journal of Asthma 44, 249–252 (2007).
Google Scholar
Liu, H. & Salvo, A. Severe air pollution and child absences when schools and parents respond. Journal of Environmental Economics and Management 92, 300–330 (2018).
Google Scholar
Watanabe, M., Noma, H., Kurai, J., Kato, K. & Sano, H. Association with ambient air pollutants and school absence due to sickness in schoolchildren: a case-crossover study in a provincial town of Japan. International Journal of Environmental Research and Public Health 18, 6631 (2021).
Google Scholar
Morphew, T., Graham, J., Rubio, K., Anderson, N. & Gentile, D. Association Between Exposure to Outdoor Air Pollution and School Absenteeism Among Asthmatic Children. Journal of Allergy and Clinical Immunology 147, AB42 (2021).
Google Scholar
Lei, J. et al. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. International journal of epidemiology 52, 715–726 (2023).
Google Scholar
Zhang, J., Wei, Y. & Fang, Z. Ozone pollution: a major health hazard worldwide. Frontiers in immunology 10, 2518 (2019).
Google Scholar
Lu, C., Yang, W., Lan, M., Li, B. & Wang, F. Effects of intrauterine and postnatal exposure to meteorological factors on childhood pneumonia. Building and Environment 244, 110800 (2023).
Google Scholar
Ngo, H. K. et al. Impact of temperature on hospital admission for acute lower respiratory infection (ALRI) among pre-school children in Ho Chi Minh City, Vietnam. International Journal of Biometeorology 65, 1205–1214 (2021).
Google Scholar
He, Q. et al. Differentiating the impacts of ambient temperature on pneumonia mortality of various infectious causes: a nationwide, individual-level, case-crossover study. EBioMedicine 98 (2023).
Tong, S., Prior, J., McGregor, G., Shi, X. & Kinney, P. Urban heat: an increasing threat to global health. bmj 375 (2021).
Zhou, L. et al. The interactive effects of extreme temperatures and PM2.5 pollution on mortalities in Jiangsu Province, China. Scientific Reports 13, 9479 (2023).
Google Scholar
Huang, Y. et al. Exploring health effects under specific causes of mortality based on 90 definitions of PM2.5 and cold spell combined exposure in Shanghai, China. Environmental Science Technology 57, 2423–2434 (2023).
Google Scholar
Mirabelli, M. C., Vaidyanathan, A., Flanders, W. D., Qin, X. & Garbe, P. Outdoor PM2.5, ambient air temperature, and asthma symptoms in the past 14 days among adults with active asthma. Environmental health perspectives 124, 1882–1890 (2016).
Google Scholar
Stocks, J., Hislop, A. & Sonnappa, S. Early lung development: lifelong effect on respiratory health and disease. The lancet Respiratory medicine 1, 728–742 (2013).
Google Scholar
Lu, C. et al. Interaction of exposure to outdoor air pollution and temperature during pregnancy on childhood asthma: Identifying specific windows of susceptibility. Building and Environment 225, 109676 (2022).
Google Scholar
Lu, C. et al. Interaction of high temperature and NO2 exposure on asthma risk: in vivo experimental evidence of inflammation and oxidative stress. Science of The Total Environment 869, 161760 (2023).
Google Scholar
Guo, Y. et al. Temperature variability and mortality: a multi-country study. Environmental health perspectives 124, 1554–1559 (2016).
Google Scholar
Sun, W., Reich, B. J., Tony Cai, T., Guindani, M. & Schwartzman, A. False discovery control in large-scale spatial multiple testing. Journal of the Royal Statistical Society Series B: Statistical Methodology 77, 59–83 (2015).
Google Scholar
McIntosh, K. Community-acquired pneumonia in children. New England Journal of Medicine 346, 429–437 (2002).
Google Scholar
Paul, S. P., Wilkinson, R. & Routley, C. Management of respiratory tract infections in children. Nursing: Research and Reviews, 135-148 (2014).
Wei, J. et al. Separating daily 1 km PM2. 5 inorganic chemical composition in China since 2000 via deep learning integrating ground, satellite, and model data. Environmental science technology 57, 18282–18295 (2023).
Google Scholar
Wei, J. et al. Satellite-derived 1-km-resolution PM1 concentrations from 2014 to 2018 across China. Environmental science technology 53, 13265–13274 (2019).
Google Scholar
Lin, L. et al. The airway microbiome mediates the interaction between environmental exposure and respiratory health in humans. Nature Medicine 29, 1750–1759 (2023).
Google Scholar
Tian, Y. et al. Ambient PM2. 5 Chemical Composition and Cardiovascular Disease Hospitalizations in China. Environmental Science Technology 58, 16327–16335 (2024).
Google Scholar
Zhang, Y. et al. Long-term PM1 exposure and hypertension hospitalization: A causal inference study on a large community-based cohort in South China. Science Bulletin 69, 1313–1322 (2024).
Google Scholar
Altman, N. S. An introduction to kernel and nearest-neighbor nonparametric regression. The American Statistician 46, 175–185 (1992).
Google Scholar
Muñoz Sabater, J. ERA5-Land hourly data from 1981 to present. Copernicus climate change service (C3S) climate data store (CDS) 10 (2019).
Chen, R. et al. Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese cities. Bmj 363 (2018).
Xu, R. et al. Socioeconomic inequality in vulnerability to all-cause and cause-specific hospitalisation associated with temperature variability: a time-series study in 1814 Brazilian cities. The Lancet Planetary Health 4, e566–e576 (2020).
Google Scholar
Chen, H., Chen, Y., Sun, B., Wen, L. & An, X. Epidemiological study of scarlet fever in Shenyang, China. BMC Infectious Diseases 19, 1–7 (2019).
Google Scholar
Wu, Y., Li, S. & Guo, Y. Space-time-stratified case-crossover design in environmental epidemiology study. Health Data Science 2021 (2021).
Mudway, I. S. et al. Impact of London’s low emission zone on air quality and children’s respiratory health: a sequential annual cross-sectional study. The Lancet Public Health 4, e28–e40 (2019).
Google Scholar
Lawrence, M. G. The relationship between relative humidity and the dewpoint temperature in moist air: A simple conversion and applications. Bulletin of the American Meteorological Society 86, 225–234 (2005).
Google Scholar
link