The focus of this study is on examining sufficiency and quality of play space in a densely populated city from the spatial perspective. The study employed a three-stage multilevel mixed-method design using spatial analysis, user questionnaire, and site surveys. Provision of play space was assessed based on location, user perception, and proximity to residential areas and roads. The spatial distribution of play space was mapped and examined by applying GIS-based multicriteria analysis. Without considering play space provided by private housing estates, the study found a mismatch between children population and location of play space. The study also identified stair, slope, and sidewalk conditions as key issues of accessibility to selected playgrounds, even in districts with sufficient play space. Kowloon has limited play space of which a high percentage is inferior in terms of safety and pollution standards. Spatial analysis can help inform optimal locations for play space. Future studies should be based on more well-rounded and complete data to advise urban planning. Additionally, policy makers should focus more on quality standards of play space (i.e., openness, absence of pollution, attraction, safety, etc.) when planning as opposed to simply meeting the minimum area per person quota for open space. Full article

This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM_2.5), particulate matter ≤10 μm (PM₁₀), ozone (O₃), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂), were positively associated with childhood asthma hospitalization, while O₃ was negatively associated with childhood asthma hospitalization. SO₂ was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution. Full article

Walking School Buses (WSBs), organized groups for children to walk to school under the supervision of adults, help reduce traffic congestion and contribute towards exercise. Routes are based largely on need, traffic safety and travel time, with exposure to air pollution not generally considered. This paper explores whether reductions in exposure can be achieved based on the side of the road travelled using data collected in Auckland, New Zealand. Exposure to air pollution was measured for a 25-min commute consisting of a 10-min segment along a quiet cul-de-sac and a 15-min segment along a main arterial road with traffic congestion heavier in one direction. Two participants were each equipped with a portable P-Trak ultrafine particle monitor and a portable Langan carbon monoxide monitor, and walked the route on opposite sides of the road simultaneously, for both morning and afternoon, logging 10-s data. The results suggest that pedestrians travelling on the footpath next to the less congested side of the road in the morning avoid many short-term peaks in concentration and experience significantly lower mean exposures than those travelling on the footpath next to the more congested side. Significant reductions in air pollution exposure could be made for children by taking into account the side of the road in WSB route design. Full article

In order to assess the pollution levels and health risks of PM_2.5-bound metals in Baoding City before and after the heating period, samples were collected in 2016 at Hebei University from September 25th to November 14th during the non-heating period, and November 15th to December 26th during the heating period, respectively. ICP-MS was applied to analyze seven heavy metals (Cr, Zn, Cu, Pb, Ni, Cd and Fe). The statistical analysis, enrichment factor (EF), pollution load index method, and Risk Assessment Method proposed by U.S. EPA were used to evaluate the non-carcinogenic risks of six of these heavy metals (Cr, Zn, Cu, Pb, Ni and Cd) and carcinogenic risks of three of these heavy metals (Cr, Ni and Cd). The results showed three main results. First, the average daily PM_2.5 concentrations of the national air monitoring stations was 155.66 μg·m⁻³ which was 2.08 times as high as that of the second level criterion in China (75 μg·m⁻³) during the observation period. Compared with the non-heating period, all heavy metals concentrations increased during heating period. The growth rates of Pb and Ni were the highest and the lowest, which were 88.03 and 5.11 percent, respectively. Second, the results of enrichment factor indicated that the EF values of all heavy metals were higher during the heating period in comparison with during the non-heating period, but the degree of enrichment of all heavy metals remained unchanged. Not only those, Cr and Ni were minimally enriched and were affected by both human and natural factors, Pb, Cu and Zn were significantly enriched and were mainly affected by human factors, the enrichment of Cd was much higher than that of the other heavy metals, exhibiting extremely high enrichment, mainly due to human factors during the whole sampling period. The results of the pollution load index indicated that the proportions of the number of highly and very highly polluted PM_2.5-bound metals were the highest during the heating period, while the proportion of moderately polluted PM_2.5-bound metals was the highest during the non-heating period. The combined pollution degree of heavy metals was more serious during the heating period. Third, according to the health risk assessment model, we concluded that the non-carcinogenic and carcinogenic risks caused by inhalation exposure were the highest and by dermal exposure were the lowest for all kinds of people. The overall non-carcinogenic risk of heavy metals via inhalation and subsequent ingestion exposure caused significant harm to children during the non-heating and the heating periods, and the risk values were 2.64, 4.47, 1.20 and 1.47, respectively. Pb and Cr exhibited the biggest contributions to the non-carcinogenic risk. All the above non-carcinogenic risks exceeded the standard limits suggested by EPA (HI or HQ < 1). The carcinogenic risk via inhalation exposure to children, adult men and women were 2.10 × 10⁻⁴, 1.80 × 10⁻⁴, and 1.03 × 10⁻⁴ during the non-heating period, respectively, and 2.52 × 10⁻⁴, 2.16 × 10⁻⁴ and 1.23 × 10⁻⁴ during the heating period, respectively. All the above carcinogenic risks exceeded the threshold ranges (10⁻⁶~10⁻⁴), and Cr posed a carcinogenic risk to all people. Full article

Premature birth is the result of a complex interaction among genetic, epigenetic, behavioral, socioeconomic, and environmental factors. We evaluated the possible associations between air pollution and the incidence of prematurity in spatial clusters of high and low prevalence in the municipality of São Paulo. It is a spatial case-control study. The residential addresses of mothers with live births that occurred in 2012 and 2013 were geo-coded. A spatial scan statistical test performed to identify possible low-prevalence and high-prevalence clusters of premature births. After identifying, the spatial clusters were drawn samples of cases and controls in each cluster. Mothers were interviewed face-to-face using questionnaires. Air pollution exposure was assessed by passive tubes (NO₂ and O₃) as well as by the determination of trace elements’ concentration in tree bark. Binary logistic regression models were applied to determine the significance of the risk of premature birth. Later prenatal care, urinary infection, and hypertension were individual risk factors for prematurity. Particles produced by traffic emissions (estimated by tree bark accumulation) and photochemical pollutants involved in the photochemical cycle (estimated by O₃ and NO₂ passive tubes) also exhibited significant and robust risks for premature births. The results indicate that air pollution is an independent risk factor for prematurity. Full article

Smog and air pollution have fast become significant environmental problems and are attributed to rapid global industrialization and urbanization. Emissions of fine particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) increase smog and air pollution, with strong impacts on human health. Children are particularly vulnerable. While increasing studies are being conducted on the behaviors leading to PM2.5 toxicity from the perspective of environmental toxicants, there is a lack of research on factors influencing anti-PM2.5 behavioral intentions. Thus, this study aims to narrow this gap by adapting the theory of planned behavior framework to investigate the effects of attitude, subjective norms, and perceived behavioral control on protective behavioral intentions against PM2.5. In total, 1277 online questionnaires were collected from parents of young children living in urban and rural areas of Beijing, and the data was analyzed using correlation, regression, and path analyses. Results revealed that there were significant differences between parents from urban and rural areas in terms of attitude (t = 4.727 > 1.96, p < 0.001), subjective norms (t = 5.529 > 1.96, p < 0.001), perceived behavioral control (t = 6.155 > 1.96, p < 0.001), and anti-PM2.5 behavioral intentions (t = 6.838 > 1.96, p < 0.001). Path analysis revealed that parents from urban and rural areas had different behavioral intention paths. For urban parents, the findings indicated that subjective norms (β = 0.73, t = 21.84 > 3.29) and perceived behavioral control (γ = 0.22, t = 6.12 > 3.29) had direct impacts on anti-PM2.5 behavioral intentions. In contrast, the attitudes (γ = 0.39, t = 3.74 > 3.29) and subjective norms (β = 0.60, t = 8.55 > 3.29) of rural parents were found to directly influence anti-PM2.5 behavioral intentions. Full article

Increases in the extent and level of air pollution in Chinese cities have become a major concern of the public and burden on the government. While ample literature has focused on the status, changes and causes of air pollution (particularly on PM_2.5 and PM₁₀), significantly less is known on their effects on people. In this study we used Hangzhou, China, as our testbed to assess the direct impact of PM_2.5 on youth populations that are more vulnerable to pollution. We used the ground monitoring data of air quality and Aerosol optical thickness (AOT) product from the Moderate Resolution Imaging Spectroradiometer (MODIS) for the spatiotemporal changes of PM_2.5 by season in 2015. We further explored these distributions with land cover, population density and schools (kindergarten, primary school and middle school) to explore the potential impacts in seeking potential mitigation solutions. We found that the seasonal variation of PM_2.5 concentration was winter > spring > autumn > summer. In Hangzhou, the percentage of land area exposed to PM_2.5 > 50 µg m⁻³ accounted for 59.86% in winter, 56.62% in spring, 40.44% in autumn and 0% in summer, whereas these figures for PM_2.5 of <35 µg m⁻³ were 70.01%, 5.28%, 5.17%, 4.16% in summer, winter, autumn and spring, respectively. As for land cover, forest experienced PM_2.5 of 35–50 µg m⁻³ (i.e., lower than those of other cover types), likely due to the potential filtering and absorption function of the forests. More importantly, a quantitative index based on population-weighted exposure level (pwel) indicated that only 9.06% of the population lived in areas that met the national air quality standards. Only 1.66% (14,055) of infants and juveniles lived in areas with PM_2.5 of <35 µg m⁻³. Considering the legacy effects of PM_2.5 over the long-term, we highly recommend improving the monitoring systems for both air quality and people (i.e., their health conditions), with special attention paid to infants and juveniles. Full article

Coal-based energy production is the most utilized method of electricity production worldwide and releases the highest concentration of gaseous, particulate, and metallic pollutants. This article aims to systematically review the public health impact of coal-fired power plant emissions on children’s health. PubMed, Web of Science, and Toxline databases were queried for the past 20 years. Inclusion criteria included original scientific articles with (a) coal-fired power plant exposure assessment, (b) at least one primary pediatric health outcome, and (c) assessment of potential sources of confounding and bias. Only morbidity and mortality studies were included; economic analysis and risk assessment studies without a primary health outcome were not included. Of 513 articles initially retrieved, 17 epidemiological articles were included in the final systematic review after screening and eligibility. The articles reviewed showed a statistically significant adverse effect on pediatric neurodevelopment; birth weight and pediatric respiratory morbidity was associated with exposure to coal-fired power plant emissions, primarily particulate matter and polyaromatic hydrocarbon exposure. There is a lack of consistency of exposure assessment and inadequate control of significant potential confounders such as social economic status. Future research should focus on improving exposure assessment models with an emphasis on source-apportionment and geographic information system methods to model power plant-specific emissions. Full article