Air pollution exposure and the burden of paediatric upper respiratory tract infections in Emergency Departments

Upper respiratory tract infections (URTI) are a major public health problem and a leading cause of pediatric Emergency Department (ED) visits. Approximately 81% of emergency outpatient visits in children are due to URTI, and respiratory diseases account for 12% of all deaths worldwide. Air pollution is considered an important factor contributing to the increased incidence of respiratory infections. The aim of this study was to examine the association between ambient air pollutant concentrations and the number of pediatric ED admissions for URTI. Methods . We conducted a retrospective analysis including 2,572 children admitted to the ED between 2015 and 2020 with a diagnosis of URTI. Daily concentrations of particulate matter (PM2.5 and PM10), carbon monoxide (CO), nitrogen oxides (NOx and NO2), ozone (O3), and sulfur dioxide (SO2) were obtained from a certified environmental monitoring station. Results . The highest number of URTI-related visits was observed in winter 2019, coinciding with the peak levels of air pollutants. In univariate analyses, higher concentrations of PM2.5, PM10, CO, and SO2 were significantly associated with increased ED admissions. After adjusting for seasonality in multivariable models, only CO and SO2 remained independent predictors of higher URTI incidence. Conclusion . Our findings indicate that air pollution is strongly associated with the frequency of pediatric URTI-related ED visits. While seasonality plays an important role, CO and SO2 appear to be key independent factors driving this association.