Air Quality and Pediatric Emergency Room Visits for Asthma and Atlanta, Georgia

• Published in: American journal of epidemiology Vol. 151; no. 8; pp. 798 - 810
• Main Authors: Tolbert, Paige E., Mulholland, James A., Macintosh, David L., Xu, Fan, Daniels, Danni, Devine, Owen J., Carlin, Bradley P., Klein, Mitchel, Butler, Andre J., Nordenberg, Dale F., Frumkin, Howard, Ryan, P. Barry, White, Mary C.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15-04-2000
• Subjects: air pollution; asthma; Biological and medical sciences; child; Chronic obstructive pulmonary disease, asthma; emergency service hospital; Medical sciences; ozone; Pneumology; Human; Respiratory disease; Ozone; Epidemiology; Asthma; Spatial distribution; Health and environment; Emergency department; Hospital consultation; Fine particle; Risk factor; Air pollution; Obstructive pulmonary disease; Child
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a010280

Pediatric emergency room visits for asthma were studied in relation to air quality indices in a spatio-temporal investigation of approximately 130,000 visits (∽6,000 for asthma) to the major emergency care centers in Atlanta, Georgia, during the summers of 1993–1995. Generalized estimating equations, logistic regression, and Bayesian models were fitted to the data. In logistic regression models comparing estimated exposures of asthma cases with those of the nonasthma patients, controlling for temporal and demographic covariates and using residential zip code to link patients to spatially resolved ozone levels, the estimated relative risk per 20 parts per billion (ppb) increase in the maximum 8-hour ozone level was 1.04 (p < 0.05). The estimated relative risk for particulate matter less than or equal to 10 μ in aerodynamic diameter (PM was 1.04 per 15 μg/m3 (p < 0.05). Exposure-response trends (p < 0.01) were observed for ozone (>100 ppb vs. <50 ppb: odds ratio = 1.23, p = 0.003) and PM10 (>60 μg/m3 vs. <20 μg/m3 odds ratio = 1.26, p = 0.004). In models with ozone and PM both terms became nonsignificant because of collinearily of the variables (r = 0.75). The other analytical approaches yielded consistent findings. This study supports accumulating evidence regarding the relation of air pollution to childhood asthma exacerbation. Am JEpidemiol 2000;151:798–810.