Pediatric Emergency Visits and Short-Term Changes in PM2.5 Concentrations in the US State of Georgia

• Type of Material: Article
• Authors: Matthew Strickland, Emory University; Hua Hao, Emory University; Xuefei Hu, Emory University; Howard Chang, Emory University; Lyndsey Darrow, Emory University; Yang Liu, Emory University
• Language: English
• Date: 2016-05-01
• Publisher: National Institute of Environmental Health Sciences (NIEHS)
• Publication Version: Final Published Version
• Copyright Statement: Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.
• Final Published Version (URL): http://dx.doi.org/10.1289/ehp.1509856
• Title of Journal or Parent Work: Environmental Health Perspectives
• ISSN: 0091-6765
• Volume: 124
• Issue: 5
• Start Page: 690
• End Page: 696
• Grant/Funding Information: Financial support was provided by the National Institutes of Health (grants R01ES019897 and K01ES019877), the U.S. Environmental Protection Agency (EPA STAR grant RD834799), and the NASA Applied Science Program (grant NNX11AI53G).
• Keywords: CHILDHOOD; DEPARTMENT VISITS; AEROSOL OPTICAL DEPTH; Environmental Sciences; Toxicology; Environmental Sciences & Ecology; CASE-CROSSOVER; AIR-POLLUTION; UNITED-STATES; HEALTH; POLLUTANTS; SMOKE EXPOSURE; Life Sciences & Biomedicine; OTITIS-MEDIA; Public, Environmental & Occupational Health
• Research Categories: Health Sciences, Toxicology; Health Sciences, Epidemiology; Environmental Sciences

Abstract

Background: Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) have been reported in previous studies, although few were performed in nonmetropolitan areas. oBjective: We estimated associations between daily PM2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state of Georgia by urbanicity classification. Methods: We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM2.5 estimates and admission dates during 1 January 2002-30 June 2010 for 2-to 18-year-olds for asthma or wheeze (n = 189,816), and for 0-to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code-level estimates of 24-hr average PM2.5 were calculated by averaging concentrations within ZIP code boundaries. We used time-stratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity. Results: A 10-μg/m3 increase in same-day PM2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant. Conclusion: Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM2.5 concentrations in Georgia.