Xiao Q, Liu Y, Mulholland JA, Russell AG, Darrow LA, Tolbert PE, Strickland MJ. Pediatric emergency department visits and ambient Air pollution in the U.S. State of Georgia: a case-crossover study.
Environ Health 2016;
15:115. [PMID:
27887621 PMCID:
PMC5124302 DOI:
10.1186/s12940-016-0196-y]
[Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 11/19/2016] [Indexed: 05/08/2023]
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 SO42-, 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.
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