Peng-Huei Liu1, Kuo-Chen Huang2, Yu-Lun Tseng3, I-Min Chiu2, Hsiu-Yung Pan2, Fu-Jen Cheng This email address is being protected from spambots. You need JavaScript enabled to view it.2 

1 Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taoyuan 33302, Taiwan
2 Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
3 Institute of Environmental Engineering, National Sun Yat-sen University, Kaohsiung 80449, Taiwan

Received: April 19, 2022
Revised: May 25, 2022
Accepted: June 8, 2022

 Copyright The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.

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Liu, P.H., Huang, K.C., Tseng, Y.L., Chiu, I.M., Pan, H.Y., Cheng, F.J. (2022). Association between Air Pollution and Risk of Hospital Admission for Pediatric Pneumonia in a Tropical City, Kaohsiung, Taiwan. Aerosol Air Qual. Res.


  • PM2.5, PM10, and SO2 were associated with risk for pediatric pneumonia hospitalization.
  • Higher PM2.5 concentration associated with prolonged hospital length of stay.
  • Younger children were more susceptible to PM2.5, PM10, and SO2 for pneumonia admission.


Recent evidences have shown that particulate matter (PM) and other air pollutants are associated with pulmonary and systemic inflammation; however, the relationship between air pollutants and the risk of admission for pediatric pneumonia has not been well surveyed. This study aimed to estimate the hazards of air pollutants on the risk of pediatric pneumonia emergency department (ED) visits and hospitalization. Data on PM2.5 (PM with an aerodynamic diameter smaller than 2.5 μm), PM10 (PM with an aerodynamic diameter smaller than 10 μm), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) in each of the 11 air monitoring stations in Kaohsiung city were collected. The medical records of non-traumatic patients under 17 years of age who had visited the ED between 2008 to 2013, with a principal diagnosis of pneumonia were extracted. We evaluated the relationship between air pollutant exposure and the risk of admission and length of hospital stay (LOS). An interquartile range increments of PM2.5 (odds ratio [OR]: 1.677, 95% confidence interval [CI]: 1.381–2.041), PM10 (OR: 1.568, 95% CI: 1.312–1.880), NO2 (OR: 1.383, 95% CI: 1.179–1.625), SO2 (OR: 1.261, 95% CI: 1.170–1.361), and O3 (OR: 1.182, 95% CI: 1.024–1.366) were statistically significantly associated with the risk of pediatric pneumonia hospitalization on lag 0–3. In the two-pollutant model, after adjusting for NO2 (OR: 1.534, 95% CI: 1.206–1.958), SO2 (OR: 1.534, 95% CI: 1.206–1.958), or O3 (OR: 1.741, 95% CI: 1.385–2.196), PM2.5 was still statistically significantly associated with pediatric pneumonia hospitalization. Furthermore, higher PM2.5 concentration (> 45 μg/m3) was associated with prolonged hospital LOS (OR: 0.217, 95% CI: 0.03–0.404, P = 0.023), especially for younger children (≤ 5 years). In conclusion, we found that PM2.5, PM10, and SO2 exposure were risk factors for hospitalization due to pediatric pneumonia.

Keywords: Particulate matter, Pneumonia, Pediatric, PM2.5, Air pollution

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