The results of this study contribute to the evidence of an association of several correlated gaseous and particulate pollutants, including ozone, NO2, CO, PM, and organic carbon, with specific respiratory conditions.

These findings provide evidence for an association between CVD visits and several correlated pollutants, including gases, PM2.5, and PM2.5 components.

Limited evidence suggests that persons with conditions such as diabetes, hypertension, congestive heart failure, and respiratory conditions may be at increased risk of adverse cardiovascular morbidity and mortality associated with ambient air pollution. The authors collected data on over 4 million emergency department visits from 31 hospitals in Atlanta, Georgia, between January 1993 and August 2000. Visits for cardiovascular disease were examined in relation to levels of ambient pollutants by use of a case-crossover framework. Heterogeneity of risk was examined for several comorbid conditions. The results included evidence of stronger associations of dysrhythmia and congestive heart failure visits with comorbid hypertension in relation to increased air pollution levels compared with visits without comorbid hypertension; similar evidence of effect modification by diabetes and chronic obstructive pulmonary disease (COPD) was observed for dysrhythmia and peripheral and cerebrovascular disease visits, respectively. Evidence of effect modification by comorbid hypertension and diabetes was observed in relation to particulate matter less than 10 microm in aerodynamic diameter, nitrogen dioxide, and carbon monoxide, while evidence of effect modification by comorbid COPD was also observed in response to ozone levels. These findings provide further evidence of increased susceptibility to adverse cardiovascular events associated with ambient air pollution among persons with hypertension, diabetes, and COPD.

Substantial evidence supports an association of particulate matter ( PM ) with cardiorespiratory illnesses, but little is known regarding characteristics of PM that might contribute to this association and the mechanisms of action. The Atlanta superstation sponsored by the Electric Power Research Institute as part of the Aerosol Research and Inhalation Epidemiology Study ( ARIES ) study is monitoring chemical composition of ambient particles by size fraction, as well as a comprehensive suite of other pollutants, at a site in downtown Atlanta during the 25 -month period, August 1, 1998 ± August 31, 2000. Our investigative team is making use of this unique resource in several morbidity studies, called the``Study of Particulates and Health in Atlanta ( SOPHIA ) ''. The study includes the following components: ( 1 ) a time series investigation of emergency department ( ED ) visits for the period during which the superstation is operating; (2) a time series investigation of ED visits during the 5 years prior to implementation of the superstation; and ( 3 ) a study of arrhythmic events in patients equipped with automatic implantable cardioverter defibrillators ( AICDs ) for the period January 1, 1993 ± August 31, 2000. Thirty -three of 39 Atlanta area EDs are participating in the ED studies, comprising over a million annual ED visits. In this paper, we present initial analyses of data from 18 of the 33 participating EDs. The preliminary data set includes 1,662,713 ED visits during the pre -superstation time period and 559,480 visits during the superstation time period. Visits for four case groupings Ð asthma, chronic obstructive pulmonary disease ( COPD ) , dysrhythmia, and all cardiovascular diseases ( CVDs ) combined Ð have been assessed relative to daily air quality indices, controlling for long -term temporal trends and meteorologic variables, using general linear models, generalized estimating equations and generalized additive models. Single -pollutant models predicting case visitation rates using moving averages of 0 -, 1 -, and 2 -day lagged air quality variables were run. For the pre -superstation period, PM 10 ( 24-h ) , ozone ( 8-h ) , SO 2 ( 1-h ) , NO 2 ( 1-h ) and CO ( 1-h ) were studied. For the first 12 months of superstation operation, the following air quality variables of a priori interest were available: ozone ( 8-h ) , NO 2 ( 1-h ) , SO 2 ( 1-h ) , CO ( 1-h ) , and 24 -h measurements of PM 10 , coarse PM ( PM 2.5 ± 10 m ) , PM 2.5 , polar VOCs, 10 ± 100 nm particulate count and surface area, and in the PM 2.5 fraction: sulfates, acidity, water -soluble metals, organic matter ( OM ) , and elemental carbon ( EC ) . During the pre -superstation time period, statistically significant, positive associations were observed for adult asthma with ozone, and for COPD with ozone, NO 2 and PM 10 . During the superstation time period, the following statistically significant, positive associations were observed: dysrhythmia with CO, coarse PM, and PM 2.5 EC; and all CVDs with CO, PM 2.5 EC and PM 2.5 OM. While ...

Driving may increase mobility and independence for adolescents with autism without intellectual disability (autism spectrum disorder); however, little is known about rates of licensure. To compare the proportion of adolescents with and without autism spectrum disorder who acquire a learner's permit and driver's license, as well as the rate at which they progress through the licensing system, we conducted a retrospective cohort study of 52,172 New Jersey residents born in the years 1987-1995 who were patients of the Children's Hospital of Philadelphia healthcare network ⩾12 years of age; 609 (1.2%) had an autism spectrum disorder diagnosis. Electronic health records were linked to New Jersey's driver licensing database (2004-2012). Kaplan-Meier curves and log-binomial regression models were used to determine the age at and rate of licensure, and estimate adjusted risk ratios. One in three adolescents with autism spectrum disorder acquired a driver's license versus 83.5% for other adolescents and at a median of 9.2 months later. The vast majority (89.7%) of those with autism spectrum disorder who acquired a permit and were fully eligible to get licensed acquired a license within 2 years. Results indicated that a substantial proportion of adolescents with autism spectrum disorder do get licensed and that license-related decisions are primarily made prior to acquisition of a permit instead of during the learning-to-drive process.