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Modelling the association of reduction in PM2.5 with medically attended acute respiratory illness in infants with mild bronchopulmonary dysplasia
  1. Timothy Nelin1,2,
  2. Joshua K Radack1,
  3. Sara B DeMauro1,3,
  4. Nicolas P Goldstein Novick1,
  5. Kristan Scott1,
  6. Allan C Just4,
  7. Heather H Burris1,2
  1. 1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania, USA
  3. 3Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  4. 4Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
  1. Correspondence to Dr Timothy Nelin; nelint{at}chop.edu

https://doi.org/10.1136/archdischild-2025-328533

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    Bronchopulmonary dysplasia (BPD) is the most common morbidity of preterm birth, affecting up to 50 000 infants each year in the USA.1 Fine particulate matter <2.5 µm in diameter (PM2.5) is a measure of air pollution, and our team recently reported that among infants diagnosed with grade 1 BPD (≤2 L/min nasal cannula at 36 weeks postmenstrual age) and discharged from a Philadelphia hospital system, each 1 μg/m3 increment of PM2.5 was associated with 65% higher odds of medically attended acute respiratory illness in the first year after neonatal intensive care unit (NICU) discharge.2 The Environmental Protection Agency recently lowered the level of the health-based standard of annual average PM2.5 exposure from 12 to 9 μg/m3. While a concentration-response association has been identified of PM2.5 with mortality, chronic obstructive pulmonary disease and asthma medication use in adults, the policy-relevant impact of reducing PM2.5 exposure among infants with BPD remains unknown.3–5

    Using the same dataset as our prior study,2 we modelled the average marginal effects of decreasing …

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    Footnotes

    • X @hhburris

    • Contributors TN and HHB conceptualised and designed the study, performed the statistical analysis, drafted the initial manuscript and critically reviewed and revised the manuscript. ACJ conceptualised and designed the study and critically reviewed and revised the manuscript. SBD critically reviewed and revised the manuscript. NPGN critically reviewed and revised the manuscript. KS critically reviewed and revised the manuscript. JKR conceptualised the study, performed the statistical analysis and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. TN is the guarantor.

    • Funding All phases of this study were supported by a NIEHS Pilot Grant from the Philadelphia Regional Center for Children’s Environmental Health (P2CES033428), a T32 award from the NIH (T32HL160493) and a Marshall Klaus Award from the American Academy of Pediatrics Section on Neonatal Perinatal Medicine (SONPM).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.