Environmental factors and the incidence of pediatric epistaxis: A systematic review with meta-analysis

Abstract

Background: A growing body of literature explores environmental risk factors for pediatric epistaxis, yielding variable results. We aim to clarify these associations through a systematic review and meta-analysis. Methods: PubMed, Scopus, Cochrane Central Register of Control Trials, Web of Science, Medline, Google Scholars, and Embase were systematically searched up to April 2024. Eligible articles were reviewed, and the quality was assessed. A systematic review and meta-analysis was conducted to clarify correlations between the incidence of epistaxis and multiple environmental factors according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: A total of 8 studies, comprising 55,176 participants, met the inclusion criteria. The incidence of epistaxis peaked during the summer months (Proportion = 12.73 , CI: 9.629 -16.201 ). Significant risk factors included environmental variables elevated in the summer, including higher monthly mean temperatures, increased sunlight exposure, elevated O3 levels, and lower atmospheric pressure. In contrast, factors like mean monthly humidity, wind speed, SO2, CO, NO2, and PM-10 levels were not associated with an increased risk of epistaxis. Conclusions: This meta-analysis underscores the significant impact of multiple environmental factors, particularly those more pronounced during the summer months, on the incidence of pediatric epistaxis.