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Original research
Association between air pollution and lung development in schoolchildren in China
  1. Tao Wang1,
  2. Haitao Wang1,
  3. Jian Chen2,
  4. Jiansheng Wang3,
  5. Dunqiang Ren4,
  6. Wei Hu1,
  7. Hongmei Wang4,
  8. Wei Han5,
  9. Shuguang Leng1,
  10. Rong Zhang6,
  11. Yuxin Zheng1
  1. 1Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
  2. 2Department of School Health, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
  3. 3Policy Research Center for Environment and Economy, Ministry of Ecology and Environment of the People’s Republic of China, Beijing, China
  4. 4Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
  5. 5Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital Group, Qingdao, China
  6. 6Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang City, China
  1. Correspondence to Yuxin Zheng, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; yxzheng{at}qdu.edu.cn

Abstract

Background China has been facing nationwide air pollution at unprecedented high levels primarily from fossil–fuel combustion in the past decade. However, few studies have been conducted on the adverse effect of severe air pollution on lung development in school-age children.

Methods Using wellness check and air pollution data from 2014 to 2017, we conducted a retrospective analysis of lung development in 21 616 school-age children from Shijiazhuang and Qingdao from North China with severe vs mild air pollution. Linear mixed effects model was performed to assess the effect of air pollution on forced vital capacity (FVC) growth.

Results Exposure to severe air pollution was associated with a dramatic reduction in annual FVC growth rate (−71.3 mL,  p< 0.001). In addition, every 10 μg/m3 increase in annual PM2.5 level was associated with a reduction of annual FVC growth by 12.2 mL ( p< 0.001). Sex discrepancy (boys vs girls) in FVC growth was greater in Qingdao (35.4 mL/year, 95% CI: 26.0 to 44.7) than in Shijiazhuang (19.8 mL/year, 95% CI: 9.3 to 30.3) (p for interaction=0.063). Exposure to indoor coal- or wood-burning stove heating (−79.4 mL,  p< 0.001) and secondhand smoke at home (−59.3 mL,  p= 0.003) were inversely associated with FVC growth.

Conclusion Our study raised serious alarm over the threat of severe air pollution to lung development in school-age children. Sex discrepancy in lung development was reduced dramatically in heavily polluted area.

  • AIR POLLUTION
  • Environmental epidemiology
  • CHILD HEALTH
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/jech-2020-214283

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    Footnotes

    • TW, HW, and JC contributed equally.

    • SL, RZ and YZ co-supervised the study.

    • Correction notice This article has been corrected since it first published online. The contributor statement has been corrected.

    • Contributors TW: Formal analysis, methodology, visualisation, data curation, writing—original draft. HW: investigation. JC: investigation. JW: investigation. DR: formal analysis. WH: investigation. HW: formal analysis. WH: formal analysis. SL: funding acquisition, supervision, writing—review & editing. RZ: investigation, writing—review & editing. YZ: funding acquisition, supervision, writing—review editing editing.

    • Funding This study was sponsored by the National Natural Science Foundation of China [91643203, 91943301, 81872600] and Guangdong Provincial Natural Science Foundation Team Project [2018B030312005]. The study funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval and consent to participate This study obtained the approval of the Institutional Review Board of Qingdao University.

    • Data sharing statement Data are available upon reasonable request.

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