Background: Air pollution, both environmental and household, is a major contributor to pediatric respiratory morbidity. Children are particularly vulnerable due to immature lungs and higher exposure rates. Objective: To assess the role of environmental and household air pollution in acute exacerbations of respiratory illnesses among children admitted to a tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted at Balaji Hospital, Raipur, involving 300 children (≤12 years) presenting with acute respiratory exacerbations. Exposure to environmental (outdoor) and household air pollution (indoor smoke, biomass fuel, tobacco smoke) was assessed through structured questionnaires. Results: Among participants, 62% had significant household pollution exposure, while 54% were exposed to high outdoor pollution. Acute exacerbations were significantly associated with indoor biomass fuel use (p<0.01), passive smoking (p<0.05), and high ambient pollution levels (p<0.01). Conclusion: Both environmental and household air pollution significantly contribute to acute respiratory exacerbations in children. Preventive strategies targeting indoor air quality and tobacco exposure are essential.
Air pollution is a major public health concern globally, particularly in developing countries like India. Children are more susceptible due to developing lungs, higher respiratory rates, and increased outdoor exposure.
Environmental pollutants such as particulate matter (PM2.5), nitrogen dioxide (NO₂), and ozone contribute to respiratory morbidity.
Household air pollution, mainly from biomass fuel and tobacco smoke, further aggravates respiratory diseases in children.
Acute exacerbations of respiratory illnesses (e.g., asthma, bronchiolitis, pneumonia) are frequently triggered by these exposures. However, hospital-based evidence from central India remains limited.
Objectives
Study Design Hospital-based cross-sectional study Study Setting Pediatric Department, Balaji Hospital, Raipur, Chhattisgarh Study Duration 12 months Study Population Children aged ≤12 years presenting with: • Acute exacerbation of asthma • Bronchiolitis • Pneumonia • Acute respiratory infections Sample Size 300 children (calculated using prevalence-based formula) Inclusion Criteria • Diagnosed respiratory illness • Acute worsening of symptoms Exclusion Criteria • Congenital lung disease • Chronic systemic illness Data Collection • Structured questionnaire (household exposure, fuel type, smoking exposure) • Clinical examination • Severity grading Exposure Variables • Indoor pollution: biomass fuel, passive smoking, poor ventilation • Outdoor pollution: traffic exposure, urban residence Statistical Analysis • Chi-square test • Logistic regression p < 0.05 considered significant
Demographic Profile
Exposure to Air Pollution
Clinical Diagnosis
Association with Exacerbations
|
Risk Factor |
Odds Ratio |
p-value |
|
Biomass fuel |
2.8 |
<0.01 |
|
Passive smoking |
2.1 |
<0.05 |
|
Outdoor pollution |
2.5 |
<0.01 |
Severity Correlation
Severe cases were significantly higher in:
Children exposed to tobacco smoke
The synergistic effect of indoor and outdoor pollution worsens clinical outcomes, increasing disease severity and hospital burden.
Environmental and household air pollution play a critical role in acute exacerbations of pediatric respiratory illnesses. Interventions targeting: • Reduction of indoor smoke • Tobacco control • Improved ventilation • Air quality monitoring are essential to reduce disease burden. Recommendations • Promote clean cooking fuels (LPG) • Awareness programs on passive smoking • Strengthen air quality policies • Routine screening of exposure in pediatric patients Limitations • Single-center study • Self-reported exposure bias • Lack of pollutant measurement devices
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