Proximity to two main sources of industrial outdoor air pollution and emergency department visits for childhood asthma in Edmonton, Canada

Abstract

OBJECTIVE: Children are recognized to be more susceptible than healthy adults to the effects of air pollution; however, relatively few Canadian studies of children have focused on industrial emissions. We conducted a spatial cross-sectional study to explore associations between emergency department (ED) visits for childhood asthma and residential proximity to two industrial sources of air pollution (coal-fired power plant and petrochemical industry) in Edmonton, Canada. METHODS:Using administrative health care data for Alberta between 2004 and 2010, we conducted a spatial analysis of disease clusters of count data around these two industrial sources. The distance from children's place of residence to these industrial sources was determined by using the six-character postal code from the children's ED visit. Clusters of cases were identified at the census dissemination area. Negative binomial multivariable spatial regression was used to estimate the risks of clusters in relation to the distance to these industrial sources. RESULTS:The relative risk of ED visits for asthma, calculated using a spatial scan test for events, was 10.4 (p value <0.01) within the power plant area when compared with the outside area. In addition, there was an inverse association of the distance to the power plant (coefficient = −0.01 per km) with asthma visits when multivariable models were used. No asthma clusters were identified around the petrochemical industrial area.CONCLUSION: Our analyses revealed that there was a cluster of ED visits for asthma among children who lived near the coal-fired power plant just outside Edmonton.KEY WORDS: Air pollution; asthma; disease cluster; industry; Canada La traduction du résumé se trouve à la fin de l'article.

Impact of Coal-fired Power Plant Emissions on Children’s Health: A Systematic Review of the Epidemiological Literature

“…A spatial cross-sectional study of children aged 2 to 14 in Alberta, Canada, assessed the association between residential proximity to a coal-fired power plant and pediatric emergency room visits for asthma [11]. Exposure assessment was based on the postal code median distance to the coal-fired power plant without modeling for emissions.…”

Improved asthma outcomes observed in the vicinity of coal power plant retirement, retrofit and conversion to natural gas

“…Several studies have characterized exposure via residential proximity to coal-fired power plants, a metric which incorporates, albeit crudely, multiple coal-related pollutants. 17 - 19 The continuous and quantitative HyADS metric improves exposure characterization around coal-fired power plants and attempts to isolate the effect of collective coal emissions on health. However, the temporal resolution of our data and the HyADS metric make it difficult to compare our findings, in magnitude, to prior research that reports relationships between coal-fired power plant exposure and increased diary-reported respiratory symptoms 12 , 13 , 40 and SABA use, 15 as well as ERVs and hospitalizations.…”

“… 16 Residential proximity to such facilities alone, without assessed air quality, has also been identified as a risk factor for asthma exacerbation. 17 - 19 …”

The Relationship of Urban Form on Children and Adolescent Health Outcomes: A Scoping Review of Canadian Evidence

“…The examination of urban form and health behaviours perhaps warrants a distinct review. While we deliberately excluded studies from our review that focussed on respiratory health and potential correlates (e.g., pollution), we also acknowledge the importance of urban form impacts on respiratory health in children [ 59 , 60 ]. Our exclusion of studies in rural settings means our review findings are generalizable to Canadian urban areas only.…”