2025/11/12 by Ewelina Wawryk‐Gawda, Nadia Miga-Orczykowska, Joanna Matusiak +3 · 1 voice
Environmental Science · Medicine · #Air Quality and Health Impacts #Climate Change and Health Impacts #Respiratory viral infections research
paper · pdf · doi:10.1007/s00431-025-06572-0
openalex publication_date 2025/11/12 · openalex created_date 2025/11/13 · openalex updated_date 2026/07/23
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. 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. Negative binomial regression models were used to estimate associations, adjusting for season, temperature, humidity, and influenza activity. 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 URTI visits. After multivariable adjustment, only carbon monoxide (IRR = 1.72, p = 0.05) and sulfur dioxide remained independently associated with higher URTI incidence, while the associations for particulate matter and nitrogen dioxide were attenuated. Ozone showed a weak inverse association, likely reflecting seasonal confounding. 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. These findings suggest that exposure to ambient CO and SO₂ may increase the risk of pediatric upper respiratory infections, highlighting the importance of air quality in the prevention of respiratory morbidity in children.