Association of short-term increases in ambient air pollution and timing of initial asthma diagnosis among medicaid-enrolled children in a metropolitan area☆

Details

• Alternative Title:
  Environ Res
• Personal Author:
  Wendt, Judy K. ; Symanski, Elaine ; Stock, Thomas H. ; Chan, Wenyaw ; Du, Xianglin L.
• Description:
  Objective ; We investigated associations of short-term changes in ambient ozone (O3), fine particulate matter (PM2.5) and nitrogen dioxide (NO2) concentrations and the timing of new-onset asthma, using a large, high-risk population in an area with historically high ozone levels. ; Methods ; The study population included 18,289 incident asthma cases identified among Medicaidenrolled children in Harris County Texas between 2005–2007, using Medicaid Analytic Extract enrollment and claims files. We used a time-stratified case-crossover design and conditional logistic regression to assess the effect of increased short-term pollutant concentrations on the timing of asthma onset. ; Results ; Each 10 ppb increase in ozone was significantly associated with new-onset asthma during the warm season (May–October), with the strongest association seen when a 6-day cumulative average period was used as the exposure metric (odds ratio OR=1.05, 95% confidence interval CI, 1.02–1.08). Similar results were seen for NO2 and PM2.5 (OR=1.07, 95% CI, 1.03–1.11 and OR =1.12, 95% CI, 1.03–1.22, respectively), and PM2.5 also had significant effects in the cold season (November–April), 5-day cumulative lag (OR=1.11. 95% CI, 1.00–1.22). Significantly increased ORs for O3 and NO2 during the warm season persisted in co-pollutant models including PM2.5. Race and age at diagnosis modified associations between ozone and onset of asthma. ; Conclusion ; Our results indicate that among children in this low-income urban population who developed asthma, their initial date of diagnosis was more likely to occur following periods of higher short-term ambient pollutant levels.
• Keywords:
  • Air pollution
  • Asthma
  • Child
  • Incidence
  • Medicaid
  • Adolescent
  • Air Pollution
  • Asthma
  • Child
  • Child, Preschool
  More +
• Source:
  Environ Res. 2014; 131:50-58
• Pubmed ID:
  24657516
• Pubmed Central ID:
  PMC4502952
• Document Type:
  Journal Article
• Funding:
  T42 OH008421/OH/NIOSH CDC HHSUnited States/ ; T42OH008421/ACL/ACL HHSUnited States/ ; 2T42OH008421/OH/NIOSH CDC HHSUnited States/
• Volume:
  131
• Download URL:
  https://stacks.cdc.gov/view/cdc/32066/cdc_32066_DS1.pdf
• File Type:
  [PDF - 661.69 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:673ae27dc9872b2353c644206a6527ffff35c193751a145370c8390413b069d0