Effects of air pollution on emergency visits for acute otitis media among children

Background Many epidemiological studies have demonstrated the short-term effects of air pollution on acute otitis media (AOM) in children, but few studies have explored the association between AOM and air pollution in Chinese children. This study aimed to analyze the effects of air pollution on emergency visits for AOM among children through a time-stratified case-crossover design in Chongqing, China. Methods The outpatient medical records of children from nine main urban districts who presented with AOM between December 22, 2018 and December 21, 2021 were collected from the Children’s Hospital of Chongqing Medical University. Data for air pollution variables, including the air quality index (AQI), particulate matter ≤ 10 μm (PM 10 ), PM 2.5 , SO 2 , CO, NO 2 and O 3 from 17 monitoring sites were collected. Data for meteorological factors as confounding variables also were collected. Conditional logistic regression was used to analyze the data with single-pollutant models, multi-pollutant models, and stratified analyses. Results Increases in AQI, PM 10 , PM 2.5 , SO 2 , CO and NO 2 were positively associated with emergency visits for AOM among children in single-pollutant models and stratified analyses. Increases in PM 10 , SO 2 , CO and NO 2 were positively associated with emergency visits for AOM among children in multi-pollutant models. NO 2 had the most statistically significant OR values in all models, whereas significant effects of O 3 were observed only in seasonal stratification. In single-pollutant models, we found that the best lag periods were lag 0–7 for air pollution variables except for O 3 and the largest OR values were 1.185 (95%CI: 1.129–1.245) for SO 2 in single-pollutant models. In stratified analyses, there were no difference between groups in these statistically significant OR values through gender and age stratification, while the differences between seasons in these OR values of PM 10 , SO 2 , CO, NO 2 and O 3 were statistically significant. Children aged 0 years and 3–5 years represented the most susceptible population, and among the seasons, susceptibility was greater during Winter and Spring. Conclusion Short-term exposure to air pollution can increase emergency visits for AOM among children in Chongqing, China

Acute otitis media · Air pollution · Alternative medicine · China · Crossover · Crossover study · Environmental health · Geography · Medical emergency · Otitis · Air Quality and Health Impacts · Computer Science · Ear Surgery and Otitis Media · Medicine · Sinusitis and nasal conditions · Pediatrics

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