Background: While the relationship between outdoor particulate matter (PM) and lower
respiratory tract infections in children and adolescents is accepted, we know little
about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory
tract infections (URTIs).Methods: We aimed to review the literature examining the
relationship between outdoor PM exposure and URTIs in children and adolescents. A
systematic search of EMBASE, MEDLINE, PubMed, Scopus, CINAHL and Web of Science databases
was undertaken on April 3, 2020 and October 27, 2021. Comparable short-term studies
of time-series or case-crossover designs were pooled in meta-analyses using random-effects
models, while the remainder of studies were combined in a narrative analysis. Quality,
risk of bias and level of evidence for health effects were appraised using a combination
of emerging frameworks in environmental health.Results: Out of 1366 articles identified,
34 were included in the systematic review and 16 of these were included in meta-analyses.
Both PM2.5 and PM10 levels were associated with hospital presentations for URTIs (PM2.5:
RR = 1.010, 95%CI = 1.007-1.014; PM10: RR = 1.016, 95%CI = 1.011-1.021) in the meta-analyses.
Narrative analysis found unequivocally that total suspended particulates were associated
with URTIs, but mixed results were found for PM2.5 and PM10 in both younger and older
children.Conclusion: This study found some evidence of associations between PM and
URTIs in children and adolescents, the relationship strength increased with PM10.
However, the number of studies was limited and heterogeneity was considerable, thus
there is a need for further studies, especially studies assessing long-term exposure
and comparing sources.