ENT - September 2020 - 513

Clinical Study

Pediatric Epistaxis and Its Correlation
Between Air Pollutants in Beijing From
2014 to 2017

Ear, Nose & Throat Journal
2020, Vol. 99(8) 513-517
ª The Author(s) 2019
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DOI: 10.1177/0145561319852581
journals.sagepub.com/home/ear

Ying-Xia Lu, MS1 , Jie-Qiong Liang, MS1, Qing-Long Gu, MS1, Chong Pang, BA1,
and Chun-Lei Huang, MS1

Abstract
Background: Epistaxis is a common symptom in children. The effect of air pollution on epistaxis is not yet clear. Objectives: To
explore the characteristics of pediatric epistaxis in Beijing and its correlation with air pollutants. Material and Methods: Data
were collected from 2014 to 2017 in Otolaryngology Department of Capital Institute of Pediatrics. Children diagnosed with
epistaxis with relevant information with the same period of municipal air pollutants' concentration were compared. Results: The
annual visits of epistaxis showed a bimodal trend. The incidence of epistaxis in infants was low, increased with age, reached the
peak between the ages of 4 to 5, and then gradually decreased with age. In different age groups, male patients were more than
females. From 2014 to 2017 in Beijing, particulate matter less than 2.5 mm in diameter (PM2.5), particulate matter less than 10 mm
in diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) showed a downtrend, lower in
summer than in the other 3 seasons. Ozone (O3) was significantly higher in 2016 and 2017, showed an increase trend in summer.
The incidence of epistaxis was negatively correlated with PM2.5, PM10, SO2, NO2 and CO, which was positively correlated with
O3 (P < .05). Conclusions: Pediatric epistaxis in Beijing changes with age and has obvious seasonal variation. There are some
correlations between air pollutants and the incidence of epistaxis in children.
Keywords
epistaxis, child, air pollutants

Background
Epistaxis is a common symptom in children. It can be caused
by nasal disease or by systemic disease. With the development
of economy, air pollution is getting more and more attention.
As the first gateway of respiratory defense, nose could be damaged by air pollutants first. The aim of the study was to investigate the characteristic of epistaxis in pediatric population in
Beijing from 2014 to 2017, and the relationship between epistaxis and the outdoor ambient air pollutants of the same period,
to better understand nasal hemorrhage, a very common symptom in children, and to assess the acute effect of air pollution on
this symptom, in order to reduce and prevent epistaxis occurrence and reasonable arrangement of medical resources.

treatment, and so on. Repeated visit within 2 weeks for the
same child was calculated as one case.
Inclusive criteria: according to the International Classification for Diseases, 10th revision (R04.000 and R04.001).
Exclusion criteria: trauma, tumor, cardiovascular system
disease, blood system disease, or other systemic diseases.

Exposure Assessment
Air pollution data in the same period was obtained from online
platform of Chinese air quality monitoring analysis (https://
www.aqistudy.cn/historydata/index.php), contained the air
quality index, air quality grade, the major pollutant, as well
as the concentration of pollutants in the 6: particulate matter

Material and Methods
1

Subjects
From the information center of Capital Institute of Pediatrics
affiliated Children's Hospital, we obtained patients' medical
information from January 1, 2014, to December 31, 2017, visited the otolaryngology department, with the diagnosis of epistaxis (it may not be the first diagnosis), including age, sex,

Department of Otolaryngology-Head and Neck Surgery, Capital Institute of
Pediatrics, Beijing, China

Received: March 20, 2019; accepted: April 24, 2019
Corresponding Author:
Qing-Long Gu, MS, Department of Otolaryngology-Head and Neck Surgery,
Capital Institute of Pediatrics, Beijing 100020, China.
Email: guqinglong71@163.com
https://www.sagepub.com/journals-permissions https://www.doi.org/10.1177/0145561319852581 http://journals.sagepub.com/home/ear https://www.orcid.org/0000-0002-9915-1508 https://www.orcid.org/0000-0002-9915-1508 https://www.aqistudy.cn/historydata/index.php https://www.aqistudy.cn/historydata/index.php
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