Etiology and pathogenesis of airway disease in children and adults from rural communities.

Schwartz, David A.

doi:10.1289/ehp.99107s3393

Cited by 29 publications

(14 citation statements)

References 129 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study of children with asthma in Fresno, CA, where PM pollution is influenced by motor vehicle traffic as well as regional agricultural activities, revealed that atopic children constituted a vulnerable subgroup in links between asthma symptoms and exposure to coarse PM (Mann et al 2010). In contrast, other researchers hypothesize that inhalation of organic dust will stimulate airway inflammation according to nonallergic mechanisms (Schwartz 1999), implying that children with asthma will be susceptible regardless of atopy status.…”

Section: Discussionmentioning

confidence: 97%

“…Rural PM tends to contain a higher proportion of organic dust (Schenker et al 1998), which is derived from plants, animal cells, insects, mold and fungi. In general, organic dusts are pro-inflammatory and cause airway inflammation and obstruction following inhalation (Schwartz 1999). These urban-rural differences in composition reflect varying PM2.5 sources.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Regional PM2.5 and asthma morbidity in an agricultural community: A panel study

Loftus

Yost

Sampson

et al. 2015

Environmental Research

View full text Add to dashboard Cite

Background Elevated pediatric asthma morbidity has been observed in rural US communities, but the role of the ambient environment in exacerbating rural asthma is poorly understood. Objectives To investigate associations between particulate matter less than 2.5 μm in diameter (PM2.5) and pediatric asthma exacerbations in an agricultural community of Washington State. Methods School-aged children with asthma (n=58) were followed for up to 25 months with repeated measures of respiratory health. Asthma symptoms and quick-relief medication use were assessed biweekly through phone administered surveys (n=2023 interviews). In addition, subjects used home peak flow meters on a daily basis to measure forced expiratory volume in one second (FEV1) (n=7830 measurements). Regional PM2.5 was measured at a single air monitor located centrally in the study region. To assess relationships between PM2.5 and these outcomes we used linear regression with generalized estimating equations, adjusting for meteorological and temporal confounders. Effect modification by atopy was explored as well. Results An interquartile increase (IQR) in weekly PM2.5 of 6.7 μg/m3 was associated with an increase in reported asthma symptoms. Specific symptoms including wheezing, limitation of activities, and nighttime waking displayed the strongest associations. FEV1 as a percent of predicted decreased by 0.9% (95%CI: −1.8, 0.0) for an IQR increase in PM2.5 one day prior, and by 1.4% (95%CI: −2.7, −0.2) when restricted to children with atopic asthma. Conclusions This study provides evidence that PM2.5 in an agricultural setting contributes to elevated asthma morbidity. Further work on identifying and mitigating sources of PM2.5 in the area is warranted.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Regional PM2.5 and asthma morbidity in an agricultural community: A panel study

Loftus

Yost

Sampson

et al. 2015

Environmental Research

View full text Add to dashboard Cite

show abstract

“…24 Asthma in inner-city and rural populations is often regarded differently based on the fact that the underlying etiologies and environmental exposures may vary to some degree. 25,26 However, both populations face similar challenges in terms of multiple barriers to adequate health care including poverty, underinsurance, and less access to health care providers. In this study, we found relatively few significant differences across the 3 sites; children treated at the urban site showed evidence of greater health care utilization, including higher rates of hospitalizations and ED visits in the last year, as well as more frequent regular asthma appointments with their regular asthma care provider.…”

Section: Discussionmentioning

confidence: 99%

Asthma Care and Management Before an Emergency Department Visit in Children in Western Michigan: How Well Does Care Adhere to Guidelines?

et al. 2006

View full text Add to dashboard Cite

OBJECTIVES. Asthma is one of the more common reasons for children's visits to the emergency departments (EDs). Many studies show that the level of asthma care and self-management in children before an ED visit for asthma is often inadequate; however, most of these studies have been conducted in the inner cities of large urban areas. Our objectives were to describe asthma care and management in children treated for asthma in 3 EDs located in an urban, suburban, or rural setting.METHODS. We studied a prospective patient cohort consisting of children aged 2 to 17 years who presented with an acute asthma exacerbation at 3 EDs in western Michigan. An in-person questionnaire was administered to the parent or guardian during the ED visit. Information was collected on demographics; asthma history; usual asthma care; frequency of symptoms during the last 4 weeks; current asthma treatment, management, and control; and past emergency asthma care. A telephone interview conducted 2 weeks after the ED visit obtained follow-up information. The 8 quality indicators of asthma care and management were defined based on recommendations from national guidelines.RESULTS. Of 197 children, 70% were enrolled at the urban site, 18% at the suburban site, and 12% at the rural site. The average age was 7.9 years; 60% were male, and 33% were black. At presentation, nearly half (46%) of the children had mild intermittent asthma, 20% had mild persistent asthma, 15% had moderate persistent asthma, and 19% had severe persistent asthma. One quarter of the children had been hospitalized for asthma, and two thirds had at least 1 previous ED visit in the past year. At least 94% had health insurance coverage and 95% reported having a primary care provider.Less than half of the children had attended at least 2 scheduled asthma appointments with their regular asthma care provider in the past year. Although only 5% of the subjects reported that the ED was their only source of asthma care, at least 30% reported that they always went directly to the ED when they needed urgent asthma care. Only 3 in 5 children possessed either a spacer or a peak-flow meter, whereas ϳ2 in 5 reported having a written asthma action plan. Among those with persistent asthma, there was considerable evidence of undertreatment, with 36% not on either an inhaled corticosteroid or a suitable long-term control medication. Only 20% completed a visit with their regular asthma care provider within 1 week of their ED visit. Despite very high levels of health care coverage and access to primary care, the overall quality of asthma care and management fell well short of that recommended by national guidelines.A STHMA IS ONE of the more common reasons for children's visits to emergency departments (EDs). 1-3 National health surveys and utilization rates of hospital services for asthma treatment indicate that the burden of asthma in US children has increased dramatically in the past 2 decades. 4,5 The number of ED visits for asthma in children Յ14 years of age increased ϳ14% in the Un...

show abstract

“…Farmers represent a high-risk group for occupational asthma and other respiratory diseases (1)(2)(3)(4)(5)(6)(7). Respiratory symptoms are more common among farmers and farm workers than other rural residents (1,(8)(9)(10).…”

mentioning

confidence: 99%

Chemical Predictors of Wheeze among Farmer Pesticide Applicators in the Agricultural Health Study

Hoppin

Umbach²,

London³

et al. 2002

Am J Respir Crit Care Med

210

164

View full text Add to dashboard Cite

Pesticides may contribute to respiratory symptoms among farmers. Using the Agricultural Health Study, a large cohort of certified pesticide applicators in Iowa and North Carolina, we explored the association between wheeze and pesticide use in the past year. Self-administered questionnaires contained items on 40 currently used pesticides and pesticide application practices. A total of 20,468 applicators, ranging in age from 16 to 88 years, provided complete information; 19% reported wheezing in the past year. Logistic regression models controlling for age, state, smoking, and history of asthma or atopy were used to evaluate associations between individual pesticides and wheeze. Among pesticides suspected to contribute to wheeze, paraquat, three organophosphates (parathion, malathion, and chlorpyrifos), and one thiocarbamate (S-ethyl-dipropylthiocarbamate [EPTC] ) had elevated odds ratios (OR). Parathion had the highest OR (1.5, 95% confidence interval [CI] 1.0, 2.2). Chlorpyrifos, EPTC, paraquat, and parathion demonstrated significant dose-response trends. The herbicides, atrazine and alachlor, but not 2,4-D, were associated with wheeze. Atrazine had a significant dose-response trend with participants applying atrazine more than 20 days/year having an OR of 1.5 (95% CI 1.2,1.9). Inclusion of crops and animals into these models did not significantly alter the observed OR. These associations, though small, suggest an independent role for specific pesticides in respiratory symptoms of farmers.

show abstract

Etiology and pathogenesis of airway disease in children and adults from rural communities.

Cited by 29 publications

References 129 publications

Regional PM2.5 and asthma morbidity in an agricultural community: A panel study

Regional PM2.5 and asthma morbidity in an agricultural community: A panel study

Asthma Care and Management Before an Emergency Department Visit in Children in Western Michigan: How Well Does Care Adhere to Guidelines?

Chemical Predictors of Wheeze among Farmer Pesticide Applicators in the Agricultural Health Study

Contact Info

Product

Resources

About