Nguyen Thi Trang Nhung1, Christian Schindler2, Tran Minh Dien3, Nicole Probst-Hensch2, Nino Künzli2. 1. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam. Electronic address: ntn2@huph.edu.vn. 2. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 3. Vietnam National Children's Hospital, Hanoi, Viet Nam.
Abstract
INTRODUCTION: The association between ambient air pollution and length of hospital stay (LOS) for children with lower-respiratory infection is unclear. MATERIALS AND METHODS: The association was examined using admission data for 75,432 children in Hanoi, aged 0-5 years, hospitalized with acute lower-respiratory infection (ALRI) and daily air pollutant levels in Hanoi between 2007 and 2016. We estimated the odds ratio of being discharged for an interquartile range (IQR) increment (IQR) of ambient pollutants during one to four days prior to admission date. We used pooled logistic regression models including a B-spline function of calendar time and terms describing the baseline odds, adjusting for meteorological factors, age, gender, residential location, week-day of admission, discharge on weekends or holidays, and number of respiratory hospitalizations one day prior to the discharge date. RESULTS: An IQR increase in O3 concentrations (85.8 μg/m3) was associated with a 5% (95%CI: 2%-8%) decrease in the odds of discharge from hospital among children with ALRI. Results were similar for PM10, but only for children aged 2-5 years. For the other pollutants, corresponding associations were close to null or in the opposite direction. For example, increase in CO was associated with shorter LOS. CONCLUSIONS: Our study provides the first investigation of the associations between lengths of hospital stays and air pollutant levels prior to hospitalization in Asian children. Increased levels of O3 prior to admission predicted prolonged hospitalizations. The inconsistencies in the findings for other pollutants call for further investigations.
INTRODUCTION: The association between ambient air pollution and length of hospital stay (LOS) for children with lower-respiratory infection is unclear. MATERIALS AND METHODS: The association was examined using admission data for 75,432 children in Hanoi, aged 0-5 years, hospitalized with acute lower-respiratory infection (ALRI) and daily air pollutant levels in Hanoi between 2007 and 2016. We estimated the odds ratio of being discharged for an interquartile range (IQR) increment (IQR) of ambient pollutants during one to four days prior to admission date. We used pooled logistic regression models including a B-spline function of calendar time and terms describing the baseline odds, adjusting for meteorological factors, age, gender, residential location, week-day of admission, discharge on weekends or holidays, and number of respiratory hospitalizations one day prior to the discharge date. RESULTS: An IQR increase in O3 concentrations (85.8 μg/m3) was associated with a 5% (95%CI: 2%-8%) decrease in the odds of discharge from hospital among children with ALRI. Results were similar for PM10, but only for children aged 2-5 years. For the other pollutants, corresponding associations were close to null or in the opposite direction. For example, increase in CO was associated with shorter LOS. CONCLUSIONS: Our study provides the first investigation of the associations between lengths of hospital stays and air pollutant levels prior to hospitalization in Asian children. Increased levels of O3 prior to admission predicted prolonged hospitalizations. The inconsistencies in the findings for other pollutants call for further investigations.
Authors: Nguyen T T Nhung; Edward Jegasothy; Nguyen T K Ngan; Ngo X Truong; Nguyen T N Thanh; Guy B Marks; Geoffrey G Morgan Journal: Int J Public Health Date: 2022-04-14 Impact factor: 5.100