Short-term association between particular matter air pollution and pediatric clinical visits for wheezing in a subarea of Shanghai

To assess the association between the concentration of ambient particulate matter (PM) and the pediatric clinical visits for wheezing among children under 3 years old, data of daily air pollutants (PM 2.5, PM 10, NO 2, SO 2, CO), meteorological reports, along with the number of daily clinical visits of the children with wheezing at the Pediatric Department of Shanghai Renji Hospital (South Campus) were collected from January through December 2014. Correlation between the levels of air pollutants and the number of clinical patients for wheezing were analyzed by a time series analysis with a generalized addictive model (GAM). During the study period, the daily average concentrations of PM 2.5, PM 10, NO 2, SO 2, and CO were 51.84 ± 32.51, 72.69 ± 41.15, 43.25 ± 18.07, 17.45 ± 10.42, and 0.82 ± 0.26 μg/m 3 , respectively, which were abnormally higher compared to the standard defined by the Chinese Ministry of Environment Protection. The average number of daily clinical patients with wheezing was 23 ± 14 persons/day. The number of clinical visit by children with wheezing was significantly correlated with concentration of PM 2.5 or PM 10 when the effect of SO 2 and NO 2 was adjusted ( P < 0.05). It was also found that exposure-response relationship was a linear non-threshold mode when it was analyzed by the GAM, and the percent of the clinical visits of children with wheezing increased from 0 to nearly 20 % with every interquartile increase of PM 2.5 . The visiting number of children at a pediatric outpatient clinic increased due to the increase of PM 2.5 in Pujiang, Shanghai, China.