Ambient Air Toxics and Asthma Prevalence among a Representative Sample of US Kindergarten-Age Children

Alexis M Stoner,Sarah E Anderson,Timothy J Buckley,Claire Thorne

doi:10.1371/journal.pone.0075176

Abstract

BackgroundCriteria pollutants have been associated with exacerbation of children’s asthma, but the role of air toxics in relation to asthma is less clear. Our objective was to evaluate whether exposure to outdoor air toxics in early childhood increased asthma risk or severity.MethodsAir toxics exposure was estimated using the 2002 National Air toxics Assessment (NATA) and linked to longitudinal data (n=6950) from a representative sample of US children born in 2001 and followed through kindergarten-age in the Early Child Longitudinal Study - Birth Cohort (ECLS-B).ResultsOverall, 17.7% of 5.5 year-olds had ever been told by a healthcare professional they had asthma, and 6.8% had been hospitalized or visited an emergency room for an asthma attack. Higher rates of asthma were observed among boys (20.1%), low-income (24.8%), and non-Hispanic black children (30.0%) (p≤0.05). Air toxics exposure was greater for minority race/ethnicity (p<0.0001), low income (p<0.0001), non-rural area (p<0.001). Across all analyses, greater air toxics exposure, as represented by total NATA respiratory hazard index, or when limited to respiratory hazard index from onroad mobile sources or diesel PM, was not associated with a greater prevalence of asthma or hospitalizations (p trend >0.05). In adjusted logistic regression models, children exposed to the highest respiratory hazard index were not more likely to have asthma compared to those exposed to the lowest respiratory hazard index of total, onroad sources, or diesel PM.ConclusionsEarly childhood exposure to outdoor air toxics in a national sample has not previously been studied relative to children’s asthma. Within the constraints of the study, we found no evidence that early childhood exposure to outdoor air toxics increased risk for asthma. As has been previously reported, it is evident that there are environmental justice and disparity concerns for exposure to air toxics and asthma prevalence in US children.

Highlights

About 7 million United States (U.S.) children have asthma and this represents a substantial public health burden
Children who were poorer or who were of minority race/ethnicity were more likely to be exposed to the highest decile across all three classes of respiratory hazard index
Relying on a nationally representative sample of United States (US) children born in 2001 and assessed from infancy through 5.5 years of age, we found no evidence that early childhood exposure to ambient air toxics as estimated by National Air toxics Assessment (NATA) was associated with increased risk for asthma or increased severity of asthma

Summary

Introduction

About 7 million United States (U.S.) children have asthma and this represents a substantial public health burden. Criteria pollutants have been extensively studied and demonstrated to cause exacerbation of children’s asthma [5,6,7,8,9,10] the evidence with respect to air toxics is much less robust and clear. Greater air toxics exposure, as represented by total NATA respiratory hazard index, or when limited to respiratory hazard index from onroad mobile sources or diesel PM, was not associated with a greater prevalence of asthma or hospitalizations (p trend >0.05). Conclusions: Early childhood exposure to outdoor air toxics in a national sample has not previously been studied relative to children’s asthma. Within the constraints of the study, we found no evidence that early childhood exposure to outdoor air toxics increased risk for asthma. As has been previously reported, it is evident that there are environmental justice and disparity concerns for exposure to air toxics and asthma prevalence in US children

Objectives

Methods

Results

Discussion

Conclusion