Associations of Air Pollution and Pediatric Asthma in Cleveland, Ohio

Sumita B Khatri,Gary A Norris,Jeffrey J Van Laere,Tanujit Dey,Cynthia Newman,Jerri A Rose,Timothy Anderson,Kristie A Ross,Matthew S Landis,Ann Holstein,Luther Smith,Shaibal Mukerjee,Jeffrey P Hammel,Mugimane Manjanatha

doi:10.1155/2021/8881390

Abstract

Air pollution has been associated with poor health outcomes and continues to be a risk factor for respiratory health in children. While higher particulate matter (PM) levels are associated with increased frequency of symptoms, lower lung function, and increase airway inflammation from asthma, the precise composition of the particles that are more highly associated with poor health outcomes or healthcare utilization are not fully elucidated. PM is measured quantifiably by current air pollution monitoring systems. To better determine sources of PM and speciation of such sources, a particulate matter (PM) source apportionment study, the Cleveland Multiple Air Pollutant Study (CMAPS), was conducted in Cleveland, Ohio, in 2009–2010, which allowed more refined assessment of associations with health outcomes. This article presents an evaluation of short-term (daily) and long-term associations between motor vehicle and industrial air pollution components and pediatric asthma emergency department (ED) visits by evaluating two sets of air quality data with healthcare utilization for pediatric asthma. Exposure estimates were developed using land use regression models for long-term exposures for nitrogen dioxide (NO2) and coarse (i.e., with aerodynamic diameters between 2.5 and 10 μm) particulate matter (PM) and the US EPA Positive Matrix Factorization receptor model for short-term exposures to fine (<2.5 μm) and coarse PM components. Exposure metrics from these two approaches were used in asthma ED visit prevalence and time series analyses to investigate seasonal-averaged short- and long-term impacts of both motor vehicles and industry emissions. Increased pediatric asthma ED visits were found for LUR coarse PM and NO2 estimates, which were primarily contributed by motor vehicles. Consistent, statistically significant associations with pediatric asthma visits were observed, with short-term exposures to components of fine and coarse iron PM associated with steel production. Our study is the first to combine spatial and time series analysis of ED visits for asthma using the same periods and shows that PM related to motor vehicle emissions and iron/steel production are associated with increased pediatric asthma visits.

Highlights

Air pollution has been associated with poor health outcomes and continues to be a risk factor for respiratory health
AMR: means ratio proportional change in the mean number of population-adjusted emergency department (ED) visits per day. bp values are summarized across the models for the different pollution components. cMinimum temperature: no MR estimates are calculated because temperature is modeled using smoothing splines. dMixing height: results are summarized as a range across the models for the different pollution components. eSeasonality: MR corresponds to a comparison to spring/ summer. fLUR quartiles: MR corresponds to a comparison to the 1st quartile
Discussion and Conclusion is study capitalized on the unique opportunity to evaluate associations between pediatric ED visits for asthma and both long- and short-term exposures to air pollutants, using measurement data collected during both periods

Summary

Introduction

Air pollution has been associated with poor health outcomes and continues to be a risk factor for respiratory health. During times of poor air quality with higher levels of air pollution, the deleterious effects are evident by acute and chronic symptomatology and development of chronic diseases, such as allergic rhinitis and asthma [5,6,7,8,9,10,11,12,13] These clinical effects occur even when PM levels are within air quality guidelines [14, 15]. Inorganic components of PM have been associated with cardiovascular- and respiratory-related hospitalizations and attributed to air pollution from motor vehicles (elemental carbon, NO2), oil combustion (nickel, vanadium), and secondarily formed aerosols from coal combustion-emitted sulfur dioxide [10, 17,18,19]

Methods

Results

Conclusion