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considered that the increase of O3 concentration in summer in
recent years is an important risk factor for the visits of children's nosebleed.
Limitations in this study that should be noted as following:
As a retrospective study, there are no detailed clinical records
to show us how many epistaxis children with definite cause,
such as allergic rhinitis, acute respiratory infection, and coagulation disorders. As we all know, air pollution has harmful
impact on rhinitis and respiratory tract infection. Therefore,
this problem largely affected our judgment of risk factors influencing epistaxis. In the future studies, this limitation should to
be addressed.

Conclusions and Significance
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.
Acknowledgment
The authors thank Prof. Ling-Hui Meng in the Department of Epidemiology, Capital Institute of Pediatrics, for assisting in the statistical
analysis of our data.

Author Contribution
Ying-Xia Lu and Jie-Qiong Liang are contributed equally to this work.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article:
Received special fund of the Pediatric Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals,
No. XTZD20180102.

ORCID iD
Ying-Xia Lu

https://orcid.org/0000-0002-9915-1508

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https://www.orcid.org/0000-0002-9915-1508 https://www.orcid.org/0000-0002-9915-1508 https://www.orcid.org/0000-0002-9915-1508

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