Meghan Hodges
Air pollution is a leading cause of pneumonia, a lung inflammation condition that affects people worldwide. It is the leading risk factor for 2.2 million annual deaths from pneumonia, with 30% of pneumonia deaths in 2021 attributed to air pollution.
Air pollution comprises various harmful substances such as particulate matter, nitrogen oxides, sulphur oxides, and volatile organic compounds. These pollutants are emitted from vehicles, industrial activities, power plants, and household sources.
Particulate matter, especially fine particles, poses a significant risk to respiratory health as they can be inhaled and penetrate deep into the lungs. This can lead to inflammation, oxidative stress, and immune system dysfunction, increasing the susceptibility to pneumonia.
Research has consistently shown a strong association between air pollution and pneumonia hospitalizations, particularly in children, the elderly, and other vulnerable groups.
Addressing air pollution is crucial to reducing the burden of pneumonia and improving respiratory health, especially in highly polluted regions.
| Characteristics | Values |
|---|---|
| Air pollution | Particulate matter (PM), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), sulphur dioxide (SO2) |
| Diseases | Stroke, ischaemic heart disease, chronic obstructive pulmonary disease, lung cancer, pneumonia, cataract, low-birth weight, small for gestational age, other cancers, diabetes, cognitive impairment, neurological diseases |
| Populations at risk | Children, elderly, pregnant women, people with lung disease, people with cardiovascular disease, people with lung cancer, current or former smokers, people with low incomes, people who are obese or have diabetes |
What You'll Learn
Air pollution and pneumonia hospitalisations in children
Air pollution is a leading risk factor for 2.2 million annual deaths from pneumonia, responsible for an estimated 30% of all pneumonia deaths in 2021. The very young are at the greatest risk, with 30% of all air pollution-related pneumonia deaths occurring in children under five.
Household sources of air pollution, such as inefficient combustion of solid fuels, are the main cause of pneumonia deaths in children under five. However, outdoor sources of air pollution, such as vehicle emissions, coal-burning power plants, and industrial activities, are also significant contributors.
Exposure to air pollution can lead to inflammation, oxidative stress, immunosuppression, and mutagenicity in cells throughout the body, impacting the lungs, heart, brain, and other organs.
Children are particularly vulnerable to the adverse effects of air pollution due to their immature pulmonary and immune systems, higher ventilation rate, and greater exposure to outdoor air pollutants.
Several studies have found a positive association between short-term exposure to air pollution and hospitalisations for pneumonia in children. A meta-analysis of 17 studies found that a 10 ug/m3 increase in particulate matter (PM10) and PM2.5 was associated with a 1.5% and 1.8% increase in hospitalisations for pneumonia, respectively.
In addition to hospitalisations, air pollution has also been linked to an increased risk of developing pneumonia in children. A meta-analysis of 21 studies found that a 10 ug/m3 increase in PM2.5 was associated with a 2.9% increase in pediatric pneumonia diagnoses.
To reduce the burden of pneumonia-related deaths and hospitalisations, it is essential to implement effective public health measures to improve air quality and reduce children's exposure to air pollution.
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Air pollution and pneumonia hospitalisations in the elderly
Air pollution is a leading risk factor for the 2.2 million annual deaths from pneumonia, responsible for an estimated 30% of all pneumonia deaths in 2021. The very young and the very old are at greatest risk, with 30% of all air pollution-related pneumonia deaths occurring in children under five years, and 42% in adults over 70.
A study in Ningbo, China, found that exposure to ambient air pollutants was associated with an increased incidence of respiratory diseases such as pneumonia, especially in younger children.
A study in Hamilton, Canada, found that long-term exposure to air pollutants was associated with an increased risk of hospitalisation for pneumonia in adults aged 65 and older. The study found that exposure to air pollution may have increased the individuals' susceptibility to pneumonia by interfering with lung immune defences.
Another study found that the effects of air pollution on the health of older adults during physical activity were harmful, particularly in relation to cardiovascular and respiratory diseases. However, the benefits of physical activity in terms of mental health outcomes were maintained, even after exposure to pollutants.
Overall, air pollution is a significant factor in pneumonia hospitalisations in the elderly.
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Air pollution and pneumonia hospitalisations by gender
Air pollution is a leading risk factor for the 2.2 million annual deaths from pneumonia, responsible for an estimated 30% of all pneumonia deaths in 2021. The particulate matter (PM) in the air, emitted from vehicles, coal-burning power plants, industrial activities, waste burning, farming practices, and household cooking and heating, is the leading cause of air pollution-related pneumonia deaths.
A study in Ningbo, China, found that exposure to ambient air pollutants was associated with an increased incidence of respiratory diseases such as pneumonia, especially in younger children. The study also found that the adverse effects of air pollutants were more severe in children aged 1 to 5 years, and adverse effects due to PM, PM10, and SO2 were more severe in girls.
Another study in Wuhan, China, found that particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and nitrogen dioxide (NO2) were significantly associated with respiratory diseases and pneumonia in young children. The odds ratios of pneumonia were 1.0179 (95% CI 1.0097-1.0260) for PM2.5 and 1.0131 (95% CI 1.0042-1.0220) for NO2 at lag 0-7 days. Subgroup analysis suggested that NO2, ozone (O3), and sulfur dioxide (SO2) only showed effects on pneumonia hospitalizations in male patients, but PM2.5 had effects on patients of both genders.
A meta-analysis of 21 studies found that every 10 μg/m3 increment in PM2.5 and PM10 resulted in a 1.0% (95% CI: 0.5–1.5) and 0.4% (95% CI: 0.2–0.6) increase in hospital admission or emergency room visit for pneumonia, respectively. Every 10 ppb increase of NO2, SO2, and O3 was associated with 3.2% (95% CI: 1.3–5.1), 2.4% (95% CI: − 2.0-7.1), and 0.4% (95% CI: 0–0.8) increase in pneumonia-specific hospital admission or emergency room visit, respectively.
A study in Qingdao, China, found that with an interquartile range increment of the density of PM2.5, PM10, NO2, and SO2 at lag 2 days, the odds ratio of hospital visits for pneumonia patients increased by 6.4% (95% CI: 2.3–10.7%), 7.7% (95% CI: 3.2–12.4%), 6.7% (95% CI: 1.0–12.7%), and 7.2% (95% CI: 1.1–13.5%), respectively. Stratified analysis showed that pollutants were more significant in the cold period. The impact of atmospheric particulates on different ages mainly occurs in young children (0 to 3-year-old).
These studies suggest that air pollution is associated with an increased risk of pneumonia hospitalizations, especially in young children, and that the risk may be higher for girls than boys. However, more research is needed to confirm these findings and understand the underlying mechanisms.
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Air pollution and pneumonia hospitalisations by socioeconomic status
Air pollution is a major health concern worldwide, with over 90% of the global population living in areas where air pollution levels exceed the World Health Organization's (WHO) recommended limits. It is the leading risk factor for 2.2 million annual deaths from pneumonia, responsible for an estimated 30% of all pneumonia deaths in 2021.
Both indoor and outdoor sources of air pollution contribute to pneumonia hospitalisations, with indoor sources accounting for 55% of air pollution-related pneumonia deaths and outdoor sources contributing to 45%. Fine particulate matter (PM2.5) is a critical pollutant, emitted from sources such as vehicles, coal-burning power plants, industrial activities, waste burning, and household cooking and heating using coal, charcoal, and wood.
Socioeconomic status is a significant factor in the vulnerability to air pollution-related pneumonia hospitalisations. A study in Catalonia, Spain, found that long-term exposure to air pollution had a larger synergistic effect on COVID-19 hospitalisations for males and those with lower individual and area-level socioeconomic status. Additionally, a study in Ningbo, China, revealed that adverse effects of air pollutants were more severe in children aged 1 to 5 years, and that adverse effects due to PM2.5, PM10, and SO2 were more pronounced in girls.
Furthermore, age is a critical factor, with the very young and the elderly being at the greatest risk. Thirty percent of all air pollution-related pneumonia deaths occur in children under five, while 42% occur in adults over 70. Household air pollution poses a greater risk for pneumonia among children, while outdoor air pollution disproportionately affects the respiratory health of older adults.
To reduce the health risks associated with air pollution and pneumonia, it is essential to implement effective public health measures, improve air quality, and protect vulnerable populations.
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Air pollution and pneumonia hospitalisations by region
Air pollution is a leading risk factor for the 2.2 million annual deaths from pneumonia, responsible for an estimated 30% of all pneumonia deaths in 2021. Air pollution is the presence of one or more contaminants in the atmosphere, such as dust, fumes, gas, mist, odour, smoke or vapour, in quantities and duration that can be injurious to human health.
A study on the association between air pollutants and pneumonia and asthma requiring hospitalisation among children under 5 years of age in Ningbo, China, from 2015 to 2017, found that PM2.5, PM10, SO2 and NO2 were significantly associated with hospitalisation for pneumonia.
Another study, which examined the association between outdoor air pollution levels and inpatient outcomes in paediatric pneumonia hospitalisations in the US from 2007 to 2008, found that higher levels of PM2.5 and O3 were associated with mortality, longer length of stay and higher costs.
A systematic review and meta-analysis on the associations between short-term exposure to air pollutants and hospital admission or emergency room visit for pneumonia found that every 10 μg/m3 increment in PM2.5 and PM10 resulted in a 1.0% and 0.4% increase in hospital admission or emergency room visit for pneumonia, respectively. In a subgroup analysis by region, PM2.5 increased hospital admission or emergency room visit for pneumonia in East Asia but not in North America.
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Frequently asked questions
Air pollution is a leading risk factor for pneumonia-related deaths, with an estimated 30% of all pneumonia deaths in 2021 being attributed to air pollution. Particulate matter (PM) is the main cause of air pollution-related pneumonia deaths. PM2.5, which is emitted from vehicles, coal-burning power plants, industrial activities, waste burning, farming practices, and household cooking and heating is the most harmful.
Air pollution can cause pneumonia by increasing susceptibility to respiratory infections and damaging lung function. Exposure to air pollution can also lead to inflammation, oxidative stress, immunosuppression, and mutagenicity in cells throughout the body.
Children, the elderly, pregnant women, and people with pre-existing health conditions, such as lung or heart disease, are at a higher risk of developing pneumonia from air pollution. Genetics, comorbidities, nutrition, and sociodemographic factors can also increase susceptibility.
Symptoms of pneumonia caused by air pollution can include wheezing, coughing, shortness of breath, susceptibility to infections, heart attacks, strokes, impaired cognitive functioning, and metabolic disorders.
To protect yourself from air pollution-related pneumonia, it is important to check the air quality forecast and avoid spending prolonged periods outdoors when the air quality is poor. Reducing exposure to air pollution, especially for vulnerable groups, can help lower the risk of developing pneumonia.
