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Open AccessArticle

Residential Ambient Traffic in Relation to Childhood Pneumonia among Urban Children in Shandong, China: A Cross-Sectional Study

by Jing Chang 1,2, Wei Liu 3,4 and Chen Huang 1,*
School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan 250357, China
Department of Building Science, Tsinghua University, Beijing 100084, China
Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing 100084, China
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(6), 1076;
Received: 9 April 2018 / Revised: 21 May 2018 / Accepted: 22 May 2018 / Published: 25 May 2018
(This article belongs to the Special Issue Air Quality and Health)
Pneumonia is a leading cause of childhood death. Few studies have investigated associations between residential ambient environmental exposures and pneumonia. In January–April 2015, we conducted a cross-sectional study in Shandong Province (China) and collected 9597 (response rate: 78.7%) parent-reported questionnaires for 3–6-year-old children from 69 urban kindergartens. We then selected 5640 children who had never changed residence since birth and examined associations between residential ambient traffic-related facilities and childhood pneumonia considering residential characteristics. Prevalence of doctor-diagnosed pneumonia during lifetime-ever was 25.9%. In the multivariate logistic regression analyses, residence close to a main traffic road (adjusted odds ratio, 95% confidence interval: 1.23, 1.08–1.40) and automobile 4S shop (1.76, 1.16–2.67) within 200 m, residence close to a filling station within 100 m (1.71, 1.10–2.65; reference: >200 m), as well as having a ground car park in the residential community (1.24, 1.08–1.42) were significantly associated with childhood pneumonia. The cumulative numbers of these traffic-related facilities had a positive dose-response relationship with the increased odds of childhood pneumonia. These associations and dose-response relationships were stronger among boys and among children with worse bedroom ventilation status during the night. Associations of residence close to the main traffic road and ground car parks in the residential community with childhood pneumonia were stronger among children living in the 1st–3rd floors than those living on higher floors. Similar results were found in the two-level (kindergarten-child) logistic regression analyses. Our findings indicate that living near traffic-related facilities is likely a risk factor for childhood pneumonia among urban children. The child’s sex, bedroom floor level, and bedroom ventilation could modify associations of ambient traffic-related facilities with childhood pneumonia. View Full-Text
Keywords: traffic; residence; pneumonia; China; children traffic; residence; pneumonia; China; children
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Chang, J.; Liu, W.; Huang, C. Residential Ambient Traffic in Relation to Childhood Pneumonia among Urban Children in Shandong, China: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2018, 15, 1076.

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