Epidemiol Health.  2022;44(1):e2022002. 10.4178/epih.e2022002.

Age-specific effects of ozone on pneumonia in Korean children and adolescents: a nationwide time-series study

Affiliations
  • 1Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • 3Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 4Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
  • 5Department of Environmental and Safety Engineering, Ajou University, Suwon, Korea
  • 6Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 7Institute of Public Health and Medical Care, Seoul National University Hospital, Seoul, Korea
  • 8Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea

Abstract


OBJECTIVES
The aim of this study was to estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents.
METHODS
We performed quasi-Poisson regression analyses for individuals of 0-4 years, 5-9 years, 10-14 years, and 15-19 years of age using nationwide time-series data from the Korea (2011-2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants.
RESULTS
A 10.0-parts per billion increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0-4 (relative risk [RR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 5-9 years of age (RR, 1.06; 95% CI, 1.04 to 1.08), but not at 10-14 (RR, 1.01; 95% CI, 0.98 to 1.04) or 15-19 years of age (RR, 1.01; 95% CI, 0.97 to 1.06). The association between ozone and hospital admissions due to pneumonia was stronger in cool seasons (from November to April) than in warm seasons (from May to October), but was similar between boys and girls.
CONCLUSIONS
Short-term exposure to ozone was associated with a higher risk of pneumonia at 0-4 years and 5-9 years of age, but not at 10-14 years or 15-19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.

Keyword

Ozone; Pneumonia; Children; Adolescent; Time-series analysis
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