Background The Asthma Predictive Index (API) and persistent wheezing phenotypes are associated with childhood asthma, but previous studies have not assessed their ability to predict objectively confirmed asthma. Objective To determine whether the University of Cincinnati API (ucAPI) and/or persistent wheezing at age three can accurately predict objectively confirmed asthma at age seven. Methods Data from the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a high risk prospective birth cohort, was used. Asthma was defined as: parent-reported or physician-diagnosed asthma objectively confirmed by a change in FEV1 of ≥ 12% post bronchodilator or a positive methacholine challenge (PC20 ≤ 4 mg/ml); or prior treatment with daily asthma controller medication(s). Multivariate logistic regression was used to investigate the relationship between confirmed asthma at age seven and a positive ucAPI (adapted and modified from prior published API definitions) and persistent wheezing at age three. Results At age seven, 103 of 589 (17.5%) children satisfied the criteria for asthma. Confirmed asthma at age seven was significantly associated with a positive ucAPI (adjusted [a]OR=13.3; 95% CI [7.0–25.2]; p<0.01) and the persistent wheezing phenotype (aOR = 9.8 [4.9–19.5]; p <0.01) at age three. Allergic persistent wheezing was associated with a significantly higher risk of asthma (aOR = 10.4 [4.1–26.0]; p<0.01) than non-allergic persistent wheezing (aOR = 5.4 [2.04–14.06]; p <0.01). Conclusions Both a positive ucAPI and persistent wheeze at age 3 years were associated with objectively confirmed asthma at age seven; however the highest risk was associated with ucAPI. These results demonstrate that the ucAPI as a clinically useful tool for predicting future asthma in school-age children.
Airborne exposure to manganese (Mn) can result in neurologic effects. Stationary air sampling is the traditional technique to assess Mn exposure for communities, yet may not accurately reflect children’s personal exposure. The goal of the study was to characterize personal exposure to Mn and PM2.5 in a cohort of children ages 7–9 years residing near a ferromanganese refinery. A subset of children living in non-smoking households ages 7–9 enrolled in the Marietta Community Actively Researching Exposure Study during March–June 2009 and 2010 were invited to participate. Blood and hair were collected and analyzed for Mn. Participants wore a PM2.5 sampler (Personal Modular Impactor) for 48 h. TWD was based on time spent at home and school and the distance of each from the refinery. Stationary outdoor air sampling was conducted 8 km from the refinery using a Harvard-type PM2.5 impactor. The relationship between personal Mn exposure and TWD was examined by multiple regression adjusting for stationary air Mn concentration, wind speed and direction, and precipitation. Complete personal air sampling data were collected on 38 children. TWD ranged from 4.7 km to 28.5 km with a mean distance of 11.1 (4.7 sd) km. Mn concentration in personal air samples ranged from 1.5 ng/m3 to 54.5 ng/m3 (geometric mean, 8.1 ng/m3). TWD was a significant predictor of natural log personal air Mn concentration (lnMn) with an associated decrease of 0.075 lnMn for each km TWD (p<0.05, 95% CI −0.13 to −0.01). Personal Mn exposures were positively associated with stationary air Mn levels and inversely associated with wind speed. A child’s location (home and school) relative to the refinery is a significant predictor of personal Mn exposure. Wind speed is also an important contributor to personal Mn exposure.
While airborne particulate matter (PM) has been associated with numerous health effects, very few studies have extensively examined the changes in exposure to PM and its health-relevant constituents, which occur in major metropolitan areas over time (e.g., 5-10 years). This study addresses changes in the PM2.5 concentration and elemental composition between two monitoring campaigns (2002-2005 and 2010-2011) carried out in the Cincinnati (Ohio, USA) metropolitan area. The area is known for high traffic volume, largely represented by diesel-powered trucks on regional freeways. The air monitoring was conducted at four sites. Through an analysis of variance comparison, differences between the two data sets were assessed for PM2.5, ten selected elements, elemental carbon (EC), organic carbon (OC), and EC/OC (a surrogate of the diesel exhaust contribution). Measured at the site that was previously found to exhibit the highest level of EC attributable to traffic, most of traffic related elements and the EC/OC ratio showed statistically significant decreases in concentration over time; however, the decrease became of borderline significance when wind variables were incorporated into the model. No major differences between data generated in the two campaigns were observed at the other monitoring stations with respect to EC/OC. Although the positive trends identified in this study (e.g., decrease in PM2.5, Ti, V, Mn, Fe, Zn, Br, and Pb, EC, OC, and EC/OC) may become sustainable in the future, no strong evidence was found that the air quality control and engine exhaust control policies implemented between 2005 and 2010 have produced significant changes in traffic air pollution levels in the entire metropolitan area. The PM monitoring Urban Transport XIX 455 results are being compared to the public perception data acquired through a specially-developed survey administered to 100 residents of the region. The data will allow establishing an association between the public perception about the ambient air quality evolution and the actual measured changes in traffic-related pollution levels.
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