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Outdoor particulate matter exposure and upper respiratory tract infections in children and adolescents: A systematic review and meta-analysis


Ziou, M and Tham, R and Wheeler, AJ and Zosky, GR and Stephens, N and Johnston, FH, Outdoor particulate matter exposure and upper respiratory tract infections in children and adolescents: A systematic review and meta-analysis, Environmental Research, 210 Article 112969. ISSN 0013-9351 (2022) [Refereed Article]

Copyright Statement

© 2022 Published by Elsevier Inc.

DOI: doi:10.1016/j.envres.2022.112969


Background: While the relationship between outdoor particulate matter (PM) and lower respiratory tract infections in children and adolescents is accepted, we know little about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory tract infections (URTIs).

Methods: We aimed to review the literature examining the relationship between outdoor PM exposure and URTIs in children and adolescents. A systematic search of EMBASE, MEDLINE, PubMed, Scopus, CINAHL and Web of Science databases was undertaken on April 3, 2020 and October 27, 2021. Comparable short-term studies of time-series or case-crossover designs were pooled in meta-analyses using random-effects models, while the remainder of studies were combined in a narrative analysis. Quality, risk of bias and level of evidence for health effects were appraised using a combination of emerging frameworks in environmental health.

Results: Out of 1366 articles identified, 34 were included in the systematic review and 16 of these were included in meta-analyses. Both PM2.5 and PM10 levels were associated with hospital presentations for URTIs (PM2.5: RR = 1.010, 95%CI = 1.007–1.014; PM10: RR = 1.016, 95%CI = 1.011–1.021) in the meta-analyses. Narrative analysis found unequivocally that total suspended particulates were associated with URTIs, but mixed results were found for PM2.5 and PM10 in both younger and older children.

Conclusion: This study found some evidence of associations between PM and URTIs in children and adolescents, the relationship strength increased with PM10. However, the number of studies was limited and heterogeneity was considerable, thus there is a need for further studies, especially studies assessing long-term exposure and comparing sources.

Item Details

Item Type:Refereed Article
Keywords:systematic review, meta-analysis, particulate matter, air pollution, upper respiratory infections, child health
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Ziou, M (Ms Myriam Ziou)
UTAS Author:Wheeler, AJ (Dr Amanda Wheeler)
UTAS Author:Zosky, GR (Professor Graeme Zosky)
UTAS Author:Stephens, N (Associate Professor Nicola Stephens)
UTAS Author:Johnston, FH (Professor Fay Johnston)
ID Code:148921
Year Published:2022
Web of Science® Times Cited:2
Deposited By:Medicine
Deposited On:2022-02-21
Last Modified:2022-09-29

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