Effect of PM2.5 Levels on Respiratory Pediatric ED Visits in a Semi-Urban Greek Peninsula

Ambient air pollution accounts for an estimated 4.2 million deaths worldwide. Particulate matter (PM)(2.5) particles are believed to be the most harmful, as when inhaled they can penetrate deep into the lungs. The aim of this study was to examine the relationship between PM2.5 daily air concentrations and pediatric emergency department (ED) visits for respiratory diseases in a Greek suburban area. All pediatric ED visits for asthma-, pneumonia- and upper respiratory infection (URI)-related complaints were recorded during the one-year period. The 24-h PM2.5 air pollution data were prospectively collected from twelve fully automated air quality monitoring stations. The mean annual concentration of PM2.5 was 30.03 mu g/m(3) (World Health Organization (WHO) Air Quality Guidelines (AQG) Annual mean concentration: 10 mu g/m(3)). PM2.5 levels rose above the WHO Air Quality Guidelines (AQG) 24-h concentrations (25 mu g/m(3))), 178 times (48.6% of the study period). When PM2.5 levels were above the daily limit, an increase of 32.44% (p < 0.001) was observed in daily pediatric ED visits for respiratory diseases and the increase was much higher during spring (21.19%, p = 0.018). A 32% (p < 0.001) increase was observed in URI-related visits, when PM2.5 levels were >= 25 mu g/m(3), compared to the mean daily visits when PM2.5 levels were <25 mu g/m(3). Air pollution levels were associated with increased pediatric ED visits for respiratory-related diseases.