Air pollution exposure and respiratory emergency visits among children in Edmonton

• Author / Creator

  Tian, Chunhui

• Ambient air pollution remains a significant public health concern in Alberta. Exposure to air pollution is associated with numerous adverse respiratory effects in children, especially wheezing, asthma, and bronchitis. Events such as wildfires can trigger an acute respiratory response due to the smoke produced. Over the past few years, Edmonton has experienced poor air quality days due to wildfire activities in Alberta and other provinces such as British Columbia. However, relatively little has been done to examine the health impacts of these events, particularly in vulnerable groups such as children.
  In this study, air pollution data and the data of respiratory visits to emergency departments (ED) among children in Edmonton between 2016 to 2018 were collected. Time-series analysis with Poisson regression was used to explore associations between air pollution (carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), fine particulate matter (PM2.5), and sulfur dioxide (SO2)) levels and daily respiratory emergency visits (wheezing, asthma, and bronchitis) among children (under 17 years of age) in the Edmonton area between 2016 to 2018, a period of heightened wildfire smoke activity. Wildfire models, non-wildfire models, and yearly models were built to explore the impacts of wildfires on children’s respiratory health. The differences between different sexes and ages were also examined. Multivariable logistic regression and multiple linear regression were applied to examine associations between air pollution levels and hospital admissions for respiratory conditions and length of stay (LOS) in ED (minutes) among children.
  Strong evidence of positive associations between daily respiratory ED visits among children in Edmonton and exposures to NO2 and O3 was found. Clear differences by sex and age were observed. Male children were found to be more affected by air pollution than female children, and older children (5-16 years old) were more affected than younger children (0-4 years old). Meanwhile, stronger associations were found in the wildfire season than in the non-wildfire season during the study period. Also, the consistency of the strongest associations, the greatest number of wildfire activities, and the strongest wildfire-related air pollution was found in 2016, the year of the Fort McMurray wildfire occurred. Additionally, hospital admissions were not associated with air pollution exposures. LOS was positively associated with exposures to NO2 and PM2.5.
  In conclusion, this study indicates evidence of positive associations between air pollution levels (NO2 and O3) and increases in daily respiratory ED visits among children under 17 years old in Edmonton between 2016 to 2018. Results also indicate the adverse impacts of wildfire-related air pollution on children’s respiratory health. The findings of this study are useful in terms of guiding health care providers, informing air quality advisories, and generating advice regarding children in Alberta. To protect children's health in Edmonton and in Canada, a recommendation is to conduct further health risk assessments and reduce children's exposure to air pollution. Meanwhile, further studies are needed to address knowledge gaps on the health impacts of wildfires. These include exploring more accurate and direct methods to measure health impacts of wildfire-related air pollution, examining the causes of increasing wildfires such as climate change, and investigating preventive measures to reduce wildfire hazards and maintain population health, especially in susceptible groups like children.

• Subjects / Keywords

  • air pollution
  • respiratory health
  • emergency visits
  • children
  • Edmonton

• Graduation date

  Spring 2022

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-pf30-qd09

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.