The association of ambient PM2.5 with school absence and symptoms in schoolchildren: a panel study

BACKGROUND: Children are a susceptible population to exposure of ambient fine particulate air pollution (PM2.5), and the associated symptoms are sensitive prevalent indicators of morbidity. However, few studies to date investigate the association between PM2.5 exposure and school absence and symptoms. METHODS: In a panel study including 20,291 observations in 615 schoolchildren 8-13 years of age, we asked the participants to record their school absence and symptoms on every school day from 17 November to 31 December 2014 in Jinan, China. We used the generalized linear mixed effects models to examine the adverse effects of ambient PM2.5 on school absence and symptoms, adjusting for covariates including meteorological and individual factors. RESULTS: The 3-day moving average of PM2.5 was significantly associated with school absence (1.37; 95% CI: 1.07-1.74) and increases in symptoms of the throat (1.03; 95% CI: 1.00-1.05), nose (1.03; 95% CI: 1.01-1.06), and skin (1.09; 95% CI: 1.06-1.12). High PM2.5 exposure also increased the risks of individual symptoms, especially for cough (1.02; 95% CI: 1.00-1.04), sneezing (1.03; 95% CI: 1.00-1.07), and stuffy nose (1.09; 95% CI: 1.02-1.17). CONCLUSION: High PM2.5 exposure is a risk factor for the health of schoolchildren. Allocation of medical resources for children should take into account the ambient PM2.5 concentrations and be proportioned accordingly.