Annals of Tropical Medicine and Public Health
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Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 44-55

A case crossover analysis of primary air pollutants association on acute respiratory infection (ARI) among children in urban region of Klang valley, Malaysia

1 Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
2 Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
3 Department of Environmental Science, Faculty of Environment Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
4 School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi; Institute for Environment and Development (Lestari), Universiti Kebangsaan Malaysia, Bangi, Malaysia

Correspondence Address:
S. N. S Ismail
Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang, Selangor
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ATMPH.ATMPH_75_17

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Introduction: Acute respiratory infection (ARI) among children is one of the health effects associated with poor air quality. Objective: This study explores the distribution of ARI cases by subtypes among children in an urban region in tropical country and its association with the air pollution level. Method: Secondary data of primary air pollutants and the ARI data recorded at the selected main public hospital in the same area from 2006 to 2010 were analyzed descriptively using statistical software and spatially through the geographical information system (GIS). Results: In total, 54,542 cases of ARI hospital admission among children were reported with 16 subtypes. Most of the ARI cases were recorded at the general hospital located in the city center (Kuala Lumpur Hospital, N = 27,719, 50.82%), and other cases were distributed at the hospitals located at suburbs (Serdang Hospital, N = 6868 (12.59%), Selayang Hospital, N = 6548, (12.01%), and Klang Hospital, N = 5434, (9.96%). Most of the patients were boys (N = 31,682, 58.09%) and aged below 5 years (N = 45,393, 83.22%). Thirteen ARI subtypes were influenced by the particulate matter with diameter size less than 10 µm (PM10), followed by NO2 (eight subtypes), CO (four sub-types), and O3 (two sub-types). PM10 contributes to high risk of acute bronchiolitis (odd ratio (OR): 1.115, 95% CI: 1.093-1.138), acute upper respiratory infection of multiple and unspecified sites (OR: 1.065, 95% CI: 1.034-1.096), and unspecified acute lower respiratory infection (OR: 1.055, 95% CI: 1.051–1.059). In conclusion, this study supported the theory that children were mainly exposed to air pollution in urban area and they were at risk to experience ARI.

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