Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China

Abstract Childhood respiratory diseases remain a major global health concern, with school-centered exposures to air pollution and extreme temperatures posing significant risks. We conducted a spatiotemporal stratified multi-city, school-based design to evaluate underexplored risk patterns of fine pa...

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Main Authors: Yangyang Wu, Jie Yang, Jing Wei, Biran Cheng, Yiyi Wang, Chen Li, Peng Wang, Hong Sun, Lei Huang
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Communications Earth & Environment
Online Access:https://doi.org/10.1038/s43247-025-02409-8
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author Yangyang Wu
Jie Yang
Jing Wei
Biran Cheng
Yiyi Wang
Chen Li
Peng Wang
Hong Sun
Lei Huang
author_facet Yangyang Wu
Jie Yang
Jing Wei
Biran Cheng
Yiyi Wang
Chen Li
Peng Wang
Hong Sun
Lei Huang
author_sort Yangyang Wu
collection DOAJ
description Abstract Childhood respiratory diseases remain a major global health concern, with school-centered exposures to air pollution and extreme temperatures posing significant risks. We conducted a spatiotemporal stratified multi-city, school-based design to evaluate underexplored risk patterns of fine particulate matter with an aerodynamic diameter ≤1 µm, nitrate, sulfate, ammonium, chloride, black carbon, and temperature exposures including daily mean, extremes, and short-term variability. The analysis included 265,076 pneumonia and/or tracheitis cases among schoolchildren in Jiangsu Province, China. We observed significant urban–rural disparities and spatial clustering in air pollution and temperature variation. Cumulative exposure to all pollutants was positively associated with increased risk of illness-related absences, with stronger effects observed in urban schools and during low-temperature conditions overall. Boys showed higher initial sensitivity to air pollution, while girls exhibited greater vulnerability after 10–14 days. Notably, urban children were most affected by combined exposures to low temperature-high pollution, whereas rural children experienced greater combined risks under high-temperature conditions. In contrast, short-term temperature variability contributed minimally to the observed health effects. These findings support the development of early warning systems for composite exposures, informed by exposure–risk profiles, to enable timely school intervention and protect schoolchildren’s respiratory health.
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series Communications Earth & Environment
spelling doaj-art-425fec17deb44471b4a2c90e645a5cbd2025-08-20T02:05:16ZengNature PortfolioCommunications Earth & Environment2662-44352025-06-016111110.1038/s43247-025-02409-8Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, ChinaYangyang Wu0Jie Yang1Jing Wei2Biran Cheng3Yiyi Wang4Chen Li5Peng Wang6Hong Sun7Lei Huang8State Key Laboratory of Water Pollution Control and Green Resource Recycling, School of the Environment, Nanjing University, 163 Xianlin Avenue, QixiaJiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of MarylandState Key Laboratory of Water Pollution Control and Green Resource Recycling, School of the Environment, Nanjing University, 163 Xianlin Avenue, QixiaSchool of Energy and Environment, Anhui University of TechnologyState Key Laboratory of Water Pollution Control and Green Resource Recycling, School of the Environment, Nanjing University, 163 Xianlin Avenue, QixiaJiangsu University, Faculty of Civil Engineering and Mechanics, 301 Xuefu Road, Jingkou DistrictJiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172State Key Laboratory of Water Pollution Control and Green Resource Recycling, School of the Environment, Nanjing University, 163 Xianlin Avenue, QixiaAbstract Childhood respiratory diseases remain a major global health concern, with school-centered exposures to air pollution and extreme temperatures posing significant risks. We conducted a spatiotemporal stratified multi-city, school-based design to evaluate underexplored risk patterns of fine particulate matter with an aerodynamic diameter ≤1 µm, nitrate, sulfate, ammonium, chloride, black carbon, and temperature exposures including daily mean, extremes, and short-term variability. The analysis included 265,076 pneumonia and/or tracheitis cases among schoolchildren in Jiangsu Province, China. We observed significant urban–rural disparities and spatial clustering in air pollution and temperature variation. Cumulative exposure to all pollutants was positively associated with increased risk of illness-related absences, with stronger effects observed in urban schools and during low-temperature conditions overall. Boys showed higher initial sensitivity to air pollution, while girls exhibited greater vulnerability after 10–14 days. Notably, urban children were most affected by combined exposures to low temperature-high pollution, whereas rural children experienced greater combined risks under high-temperature conditions. In contrast, short-term temperature variability contributed minimally to the observed health effects. These findings support the development of early warning systems for composite exposures, informed by exposure–risk profiles, to enable timely school intervention and protect schoolchildren’s respiratory health.https://doi.org/10.1038/s43247-025-02409-8
spellingShingle Yangyang Wu
Jie Yang
Jing Wei
Biran Cheng
Yiyi Wang
Chen Li
Peng Wang
Hong Sun
Lei Huang
Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
Communications Earth & Environment
title Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
title_full Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
title_fullStr Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
title_full_unstemmed Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
title_short Extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in Jiangsu province, China
title_sort extreme temperatures amplify air pollution risks to childhood respiratory health in school environment in jiangsu province china
url https://doi.org/10.1038/s43247-025-02409-8
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