Background: Respiratory diseases are a major component of morbidity in children and their symptoms may be spatially and temporally exacerbated by exposure gradients of fine particulate matter (PM2.5) in large polluted urban areas, like the Mexico City Metropolitan Area (MCMA). Objectives: To analyze the association between satellite-derived and interpolated PM2.5 estimates with children's (≤9 years old) acute respiratory symptoms (ARS) in two probabilistic samples representing the MCMA. Methods: We obtained ARS data from the 2006 and 2012 National Surveys for Health and Nutrition (ENSaNut). Two week average exposure to PM2.5 was assessed for each household with spatial estimates from a hybrid model with satellite measurements of aerosol optical depth (AOD-PM2.5) and also with interpolated PM2.5 measurements from ground stations, from the Mexico City monitoring network (MNW-PM2.5). We used survey-adjusted logistic regressions to analyze the association between PM2.5 estimates and ARS reported on children. Results: A total of 1,005 and 1,233 children were surveyed in 2006 and 2012 representing 3.1 and 3.5 million children, respectively. For the same years and over the periods of study, the estimated prevalence of ARS decreased from 49.4% (95% CI: 44.9,53.9%) to 37.8% (95% CI: 34,41.7%). AOD-PM2.5 and MNW-PM2.5 estimates were associated with significantly higher reports of ARS in children 0–4 years old [OR2006 = 1.29 (95% (CI): 0.99,1.68) and OR2006 = 1.24 (95% CI: 1.08,1.42), respectively]. We observed positive non-significant associations in 2012 in both age groups and in 2006 for children 5–9 years old. No statistically significant differences in health effect estimates of PM2.5 were found comparing AOD-PM2.5 or MNW-PM2.5 for exposure assessment. Conclusions: Our findings suggest that PM2.5 is a risk factor for the prevalence of ARS in children and expand the growing evidence of the utility of new satellite AOD-based methods for estimating health effects from acute exposure to PM2.5.

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Environmental Research
Department of Epidemiology

Téllez-Rojo, M.M. (Martha M.), Rothenberg, S.J. (Stephen J.), Texcalac-Sangrador, J.L. (José Luis), Just, A.C. (Allan C.), Kloog, I. (Itai), Rojas-Saunero, L.P. (Liliana Paloma), … Riojas-Rodríguez, H. (Horacio). (2020). Children's acute respiratory symptoms associated with PM2.5 estimates in two sequential representative surveys from the Mexico City Metropolitan Area. Environmental Research. doi:10.1016/j.envres.2019.108868