The Impact Of Temperature Variation And Air Pollutants On Children In Shanghai

Objectives1. Evaluate the impact of temperature variation on pediatric fever visits in Shanghai. Temperature variation can be in one of the following forms:daily mean temperature, daily range of temperature, difference of daily mean temperature between adjacent days, difference of temperature value at8:00and the one at20:00, difference of tem-perature value at8:00and the one at14:00, and the absolute values of the differences.2. Clarify the effect distribution of daily mean temperatures of one week on pediatric respiratory visits among children covered by medical insurance in Shanghai. Moreo-ver, based on the association between them, a forecast is made.3. Explore the impact of temperature variation on children burns in Shanghai. Evaluate the exposure effect of air pollutants on children burns in Shanghai, besides their in-teractions with daily mean temperature.MethodsData of pediatric fever visits from2006/1/1to2010/8/23, respiratory visits of chil-dren covered by medical insurance from2008/4/1to2010/12/31and pediatric burns from2002/1/1to2010/12/31are collected. Daily meteorological data and daily air pollution data of the corresponding period are achieved, too. Mixed generalized additive mod-el(MGAM) was used to analyze time series. After controlling for time trend, day of week, vocation and other confounders if necessary, the impact of daily temperature and air pol-lutants on children health are explored, including the exposure effect of air pollutants, the effect distribution of daily temperature, the temperature action curve, and a forecast mod-el.Results 1. Temperature variation has an impact on pediatric fever visits in Shanghai, which in-cludes daily mean temperature, daily range of temperature, difference of daily mean temperature between adjacent days, difference of temperature value at8:00and the one at20:00, difference of temperature value at8:00and the one at14:00, and the absolute values of the differences. The pediatric fever visits increases with the in-creasing temperature variation. Daily mean temperature demonstrates the strongest effect of all forms of temperature variation.2. Pediatric respiratory visits among children covered by medical insurance in Shanghai are related to temperatures of one week. Daily mean temperature of that very day has the strongest impact, which is followed by that of three days before. Weighted tem-perature over one week affect pediatric respiratory visits among children covered by medical insurance, forming an asymmetric bell shaped curve with12.9℃as the threshold temperature. The fitted model has a favorable ability of forecasting.3. Daily mean temperature affects children burns in Shanghai, forming an upward slop-ing curve after its first drop with7.4℃as the threshold temperature. The children burns increase rapidly when the daily mean temperature is above about27℃. All of the three air pollutants have impact on pediatric burns. The week-effect of NO2shows an interaction with daily mean temperature while both of the week-effect and month-effect of SO2interact with daily mean temperature. Each increase of10μg/m3in the average concentration of PM10of one day, that of one week and that of one month was found to correspond, respectively, to a relative risk of1.004,1.014and1.005in pediatric burns. Each increase of10μg/m3in the average concentration of SO2of one day, that of one week at medium temperature band, that of one week at high temperature band, that of one month at low temperature band, that of one month at medium temperature band, that of one month at high temperature band, and that of one year was found to correspond, respectively, to a relative risk of1.015,1.050,1.052,1.048,1.042,1.108and2.578in pediatric burns. Each increase of1Oμg/m3in the average concentration of NO2of one week at medium temperature band, that of one month and that of one year was found to correspond, respectively, to a relative risk of1.028,1.068and3.260in pediatric burns.Conclusion Daily temperature variation and the concentration of air pollutants have an impact on children health in Shanghai. The association of temperature and air pollutants with children health are helpful for parents to be prepared to prevent children diseases. More-over, it supports administrators of medical services to allocate resources efficiently and monitor the emergency.