Abstract
Air pollution is considered a risk factor for asthma. In this paper, we analyze the association between daily hospital admissions for asthma and ambient air pollution concentrations in four New York City counties. Negative binomial regression is used to model the association between daily asthma hospital admissions and ambient air pollution concentrations. Potential confounding factors such as heat index, day of week, holidays, yearly population changes, and seasonal and long-term trends are controlled for in the models. Nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO) show the most consistent statistically significant associations with daily hospitalizations for asthma during the entire period (1996-2000). The associations are stronger for children (0 - 17 years) than for adults (18 - 64 years). Relative risks (RR) for the inter-quartile range (IQR) of same day 24-hour average pollutant concentration and asthma hospitalizations for children for the four county hospitalization totals were: NO2 (IQR = 0.011 ppm, RR = 1.017, 95% CI = 1.001, 1.034), SO2 (IQR = 0.008 ppm, RR = 1.023, 95% CI = 1.004, 1.042), CO (IQR = 0.232 ppm, RR = 1.014, 95% CI = 1.003, 1.025). In the case of ozone (O3) and particulate matter (PM2.5) statistically significant associations were found for daily one-hour maxima values and children’s asthma hospitalization in models that used lagged values for air pollution concentrations. Five-day weighted average lag models resulted in these estimates: O3 (one-hour maxima) (IQR = 0.025 ppm, RR = 1.049, 95% CI = 1.002, 1.098), PM2.5 (one-hour maxima) (IQR = 16.679 μg/m3, RR = 1.055, 95% CI = 1.008, 1.103). In addition, seasonal variations were also explored for PM2.5 and statistically significant associations with daily hospital admissions for asthma were found during the colder months (November-March) of the year. Important differences in pollution effects were found across pollutants, counties, and age groups. The results for PM2.5 suggest that the composition of PM is important to this health outcome, since the major sources of NYC PM differ between winter and summer months.
Highlights
Asthma is a chronic health condition characterized by wheezing, breathlessness, chest tightness, and coughing
The models suggest that statistically significant associations are common for asthma hospitalizations with SO2, NO2, carbon monoxide (CO), and to a lesser extent O3 and PM2.5
The models for asthma hospitalizations for the four county hospitalization totals show that statistically significant associations between the pollutants and asthma hospitalizations are more common for children than for adults but when all age groups are combined for the asthma hospitalization data there are statistically significant associations for all the pollutants considered
Summary
Asthma is a chronic health condition characterized by wheezing, breathlessness, chest tightness, and coughing. According to the Centers for Disease Control and Prevention (CDC), some 16.4 million people in the US, and over 9% of children, have asthma. Asthma is one of the costliest diseases. In the same year 4055 people died of asthma [1]. Genetic predisposition and environmental factors have been identified in the development of asthma. Key environmental factors include allergen exposure, environmental tobacco smoke, nutrition, socioeconomic status, low birth weight, history of infections, and air pollutants [2]. Poor people are considered to be more susceptible to environmental and socio-economic stressors, including air pollution [3,4]. In New York City the distribution of hospitalizations and emergency room visits for asthma indicates that the burden of this disease falls disproportionately on poor communities [5]. Traffic-related pollutants may contribute to the onset of asthma [7,8,9]
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