Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home

Abstract

Background: Aggregate hospital encounters for asthma (admissions or emergency department visits) have been associated with daily regional air pollution. There are fewer data on relationships between repeated hospital encounters and traffic-related air pollution near the home.Objective: To estimate the association of local traffic-generated air pollution with repeated hospital encounters for asthma in children.Methods: Hospital records for 2,768 children aged 0 to 18 years (697 of whom had Ն2 encounters) were obtained for a catchment area of 2 hospitals in northern Orange County, California. Residential addresses were geocoded. A line source dispersion model was used to estimate individual seasonal exposures to local traffic-generated pollutants (nitrogen oxides and carbon monoxide) longitudinally beginning with the first hospital encounter. Recurrent proportional hazards analysis was used to estimate risk of exposure to air pollution adjusting for sex, age, health insurance, census-derived poverty, race/ethnicity, residence distance to hospital, and season. The adjustment variables and census-derived median household income were tested for effect modification.Results: Adjusted hazard ratios for interquartile range increases in nitrogen oxides (4.00 ppb) and carbon monoxide (0.056 ppm) were 1.10 (95% confidence interval, 1.03-1.16) and 1.07 (1.01-1.14), respectively. Associations were strongest for girls and infants but were not significantly different from other groups. Stronger associations in children from higher-income block groups (P Ͻ .09 for trend) may have been due to more accurate data.Conclusions: Associations for repeated hospital encounters suggest that locally generated air pollution near the home affects asthma severity in children. Risk may begin during infancy and continue in later childhood, when asthma diagnoses are clearer.

Epidemiology and outcome of childhood asthma: a clinical study in an Egyptian university medical centre

“…This is not consistent with other studies [18,19]. Passive tobacco smoking and exposure to outdoor dust and smoke were significant risk factors in the prevalence of asthma but had no significant effect on the need for hospital admission in our study, whereas other studies showed that exposure to smoke increased the severity of asthma and the need for hospital admission [14,20]. These differences between our study and others may be due to the small number of cases in our study, and ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫التاسع‬ ‫املجلد‬ ‫السادس‬ ‫العدد‬ the small numbers hospitalized, which may have affected the likelihood of findings significant differences.…”

The Assessment of Road Traffic Air Pollution by Means of an Average Emission Parameter

“…(5) and (6), the YAV indicator allows easy evaluations of pollutant emission loads discharged by a specific transportation system, even in correspondence of several hypothetical scenarios in turn correlated to different values of N tot | Ty c and L c .…”

“…Indeed, an estimated 10 % of the global pollution is generated by road vehicles which are furthermore accountable for 20 % of the European anthropogenic CO 2 emissions [4], while local impact of various air pollutants generated by road traffic, such as CO, NOx SO 2 , and particulate matter with a diameter of 10 micrometres or less (PM 10 ), has been documented [5][6][7].…”

Poluição veicular e saúde da população: uma revisão sobre o município de São Paulo (SP), Brasil

“…O tráfego ainda foi responsável por 25 mil novos casos de bronquite crônica em adultos, mais de 290 mil casos de bronquite em crianças e 500 mil de ataques de asma 50 . Diversos outros estudos utilizaram métodos semelhantes [51][52][53] . Estudos deste tipo são viáveis para o município de São Paulo, sendo a maior dificuldade a qualidade dos dados disponíveis para a alimentação do modelo e sua vantagem é a possibilidade de análise, com alta resolução, de cenários envolvendo medidas de controle, como restrição do uso de veí-culos, mudança de combustíveis ou de perfil da frota.…”