Pediatric emergency department visits and ambient Air pollution in the US State of Georgia: a case-crossover study

• Type of Material: Article
• Authors: Qingyang Xiao, Emory University; Yang Liu, Emory University; James A. Mulholland, Georgia Institute of Technology; Armistead G. Russell, Georgia Institute of Technology; Lyndsey Darrow, Emory University; Paige Tolbert, Emory University; Matthew J. Strickland, University of Nevada
• Language: English
• Date: 2016-11-25
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2016 The Author(s). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12940-016-0196-y
• Title of Journal or Parent Work: Environmental Health
• ISSN: 1476-069X
• Volume: 15
• Issue: 1
• Start Page: 1
• End Page: 8
• Grant/Funding Information: IH grant K01ES019877 and EPA STAR grant RD834799.
• Keywords: Environmental Sciences; Air pollution; FINE PARTICULATE MATTER; MEASUREMENT ERROR; TIME-SERIES; Science & Technology; HOSPITAL ADMISSIONS; POLLUTANTS; Pediatric Emergency Department Visits; Multipollutant model; HEALTH; ATLANTA; MULTIPOLLUTANT EXPOSURE; ASTHMA; SHORT-TERM ASSOCIATIONS; Public, Environmental & Occupational Health; Environmental Sciences & Ecology; CMAQ; Life Sciences & Biomedicine
• Research Categories: Environmental Sciences; Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Background: Estimating the health effects of ambient air pollutant mixtures is necessary to understand the risk of real-life air pollution exposures. Methods: Pediatric Emergency Department (ED) visit records for asthma or wheeze (n = 148,256), bronchitis (n = 84,597), pneumonia (n = 90,063), otitis media (n = 422,268) and upper respiratory tract infection (URI) (n = 744,942) were obtained from Georgia hospitals during 2002–2008. Spatially-contiguous daily concentrations of 11 ambient air pollutants were estimated from CMAQ model simulations that were fused with ground-based measurements. Using a case-crossover study design, odds ratios for 3-day moving average air pollutant concentrations were estimated using conditional logistic regression, matching on ZIP code, day-of-week, month, and year. Results: In multipollutant models, the association of highest magnitude observed for the asthma/wheeze outcome was with “oxidant gases” (O3, NO2, and SO2); the joint effect estimate for an IQR increase of this mixture was OR: 1.068 (95% CI: 1.040, 1.097). The group of “secondary pollutants” (O3 and the PM2.5 components SO4 2−, NO3−, and NH4+) was strongly associated with bronchitis (OR: 1.090, 95% CI: 1.050, 1.132), pneumonia (OR: 1.085, 95% CI: 1.047, 1.125), and otitis media (OR: 1.059, 95% CI: 1.042, 1.077). ED visits for URI were strongly associated with “oxidant gases,” “secondary pollutants,” and the “criteria pollutants” (O3, NO2, CO, SO2, and PM2.5). Conclusions: Short-term exposures to air pollution mixtures were associated with ED visits for several different pediatric respiratory diseases.