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Correlations between ambient air pollution and the prevalence of hospitalisations and emergency room visits for respiratory diseases in children: a systematic review
  1. Aline Priscila de Souza1,
  2. Carla Cristina Souza Gomez2,
  3. Maria Angela Gonçalves de Oliveira Ribeiro2,
  4. Paula Dornhofer Paro Costa3,
  5. José Dirceu Ribeiro4
  1. 1Child and Adolescent Health, State University of Campinas Faculty of Medical Sciences, Campinas, Sao Paulo, Brazil
  2. 2State University of Campinas, Campinas, Brazil
  3. 3Computer Engineering and Industrial Automation, State University of Campinas, Campinas, Brazil
  4. 4Pediatrics, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil
  1. Correspondence to Aline Priscila de Souza, Child and Adolescent Health, State University of Campinas Faculty of Medical Sciences, Campinas, Sao Paulo 13083, Brazil; aline_priscila2014{at}


Objective It is known that exposure to air pollution is associated with an increased risk for cardiovascular and respiratory diseases. This review aimed to summarise observational studies on the impact of short and long-term exposure to ambient air pollution on prevalence of hospitalisations and/or emergency department visits caused by respiratory diseases in children and adolescents.

Sources Pubmed, Scopus, Embase and Cochrane Library databases were searched for the years 2018 to December 2022, including studies in any language.

Summary of the findings A total of 15 studies published between 2018 and 15 January 2022 were included in this review. PM2.5 was the most type of particulate matter studied. Short-term exposure to PM2,5, PM10, NO2, SO2 and O3, even at concentrations less than the current health-based guidelines, was significantly correlated with increased risk of outpatient/hospital visits and hospitalisations for respiratory diseases by children.

Conclusions Our findings emphasise the importance and urgency of long-term control of air pollution and pollution-related diseases, especially among children and adolescents. There is a need for further research employing more homogeneous methodologies for assessing exposure and outcome measurements, in order to enable systematic reviews with meta-analysis.

  • Child Health
  • Global Health
  • Respiratory Medicine
  • Adolescent Health

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  • Contributors The authors confirm their contribution to the paper as follows: study conception and design: APdS, JDR, PDPC and CCSG; data collection: APdS and CCSG; analysis and interpretation of results: APdS, JDR, PDPC and CCSG; draft manuscript preparation: APdS, MAGdOR and CCSG. All authors reviewed the results and approved the final version of the manuscript.

  • Funding This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. Process: 88881.859218/2023-01. Project: 88887.593131/2020-00—UNICAMP—State University of Campinas. Grant Number: 1577/2023.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.