A Review of Airborne Particulate Matter Effects on Young Children's Respiratory Symptoms and Diseases

Exposure to airborne fine particulate matter (PM2.5) carries substantial health risks, particularly for younger children (0-10 years). Epidemiological evidence indicates that children are more susceptible to PM health effects than adults. We conducted a literature review to obtain an overview of existing knowledge regarding the correlation of exposure to short-and long-term PM concentrations with respiratory symptoms and disease in children. A collection of scientific papers and topical reviews were selected in cooperation with two experienced paediatricians. The literature review was performed using the keywords "air pollution", "particulate matter", "children's health" and "respiratory" from 1950 to 2016, searching the databases of Scopus, Google Scholar, Web of Science, and PubMed. The search provided 45,191 studies for consideration. Following the application of eligibility criteria and experts' best judgment to titles and abstracts, 28 independent studies were deemed relevant for further detailed review and knowledge extraction. The results showed that most studies focused mainly on the effect of short-term exposure in children, and the reported associations were relatively homogeneous amongst the studies. Most of the respiratory diseases observed in outdoor studies were related to changes in lung function and exacerbation of asthma symptoms. Allergic reactions were frequently reported in indoor studies. Asthma exacerbation, severe respiratory symptoms and moderate airway obstruction on spirometry were also observed in children due to various sources of indoor pollution in households and schools. Mixed indoor and outdoor studies indicate frequent occurrence of wheezing and deterioration of lung function. There is good evidence of the adverse effect of short-term exposure to PM on children's respiratory health. In terms of long-term exposure, fine particles (PM0.1-PM2.5) represent a higher risk factor than coarse particles (PM2.5-PM10). Additional research is required to better understand the heterogeneous sources and the association of PM and adverse children's health outcomes. We recommend long-term cooperation between air quality specialists, paediatricians, epidemiologists, and parents in order to improve the knowledge of PM effects on young children's respiratory health.