Abstract
Background
Social and environmental stressors may modify associations between environmental pollutants and asthma symptoms. We examined if neighborhood asthma prevalence (higher: HAPN vs. lower: LAPN), a surrogate for underlying risk factors for asthma, modified the relationship between pollutants and urgent asthma visits.
Methods
Through zip code, home addresses were linked to New York City Community Air Survey’s land use regression model for street-level, annual average nitrogen dioxide (NO2), particulate matter (PM2.5), elemental carbon (EC), summer average ozone (O3), winter average sulfur dioxide (SO2) concentrations. Poisson regression models were fit to estimate the association (prevalence ratio, PR) between pollutant exposures and seeking urgent asthma care.
Results
All pollutants, except O3 were higher in HAPN than LAPN (P < 0.01). Neighborhood asthma prevalence modified the relationship between pollutants and urgent asthma (P-interaction < 0.01, for NO2 and SO3). Associations between pollutants and urgent asthma were observed only in LAPN (NO2: PR = 1.38, P = 0.01; SO3: PR = 1.85, P = 0.04). No association was observed between pollutants and urgent asthma among children in HAPN (P > 0.05).
Conclusions
Relationships between modeled street-level pollutants and urgent asthma were stronger in LAPN compared to HAPN. Social stressors that may be more prevalent in HAPN than LAPN, could play a greater role in asthma exacerbations in HAPN vs. pollutant exposure alone.
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References
Papi, A., Brightling, C., Pedersen, S. E., Reddel, H. K. Asthma. Lancet. 391, 783–800 (2017).
Norris, G. et al. An association between fine particles and asthma emergency department visits for children in Seattle. Environ. Health Perspect. 107, 489–493 (1999).
Strickland, M. J. et al. Short-term associations between ambient air pollutants and pediatric asthma emergency department visits. Am. J. Respir. Crit. Care Med. 182, 307–316 (2010).
Villeneuve, P. J., Chen, L., Rowe, B. H. & Coates, F. Outdoor air pollution and emergency department visits for asthma among children and adults: a case-crossover study in northern Alberta, Canada. Environ. Health 6, 40 (2007).
Moore, K. et al. Ambient ozone concentrations cause increased hospitalizations for asthma in children: An 18-year study in Southern California. Environ. Health Perspect. 116, 1063–1070 (2008).
Gent, J. F. et al. Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. JAMA 290, 1859–1867 (2003).
Delfino, R. J. et al. Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home. Ann. Allergy Asthma Immunol. 102, 138–144 (2009).
Newman, N. C. et al. Traffic-related air pollution and asthma hospital readmission in children: a longitudinal cohort study. J. Pediatr. 164, 1396–1402 e1391 (2014).
Gold, D. R. & Wright, R. Population disparities in asthma. Annu Rev. Public Health 26, 89–113 (2005).
Houston, D., Wu, J., Ong, P. & Winer, A. Structural disparities of urban traffic in Southern California: implications for vehicle-related air pollution exposure in minority and high-poverty neighborhoods. J. Urban Aff. 26, 565–592 (2004).
Milligan, K. L., Matsui, E., Sharma, H. Asthma in Urban Children: Epidemiology, Environmental Risk Factors, and the Public Health Domain. Curr. Allergy and Asthma Rep. 16, 1–10 (2016).
Patel, M. M. et al. Traffic density and stationary sources of air pollution associated with wheeze, asthma, and immunoglobulin E from birth to age 5 years among New York City children. Environ. Res 111, 1222–1229 (2011).
Kheirbek, I., Wheeler, K., Walters, S., Kass, D. & Matte, T. PM2.5 and ozone health impacts and disparities in New York City: sensitivity to spatial and temporal resolution. Air Qual. Atmos. Health 6, 473–486 (2013).
Yu, C. H. et al. A novel mobile monitoring approach to characterize spatial and temporal variation in traffic-related air pollutants in an urban community. Atmos. Environ. 141, 161–173 (2016).
Patton, A. P. et al. Spatial and temporal differences in traffic-related air pollution in three urban neighborhoods near an interstate highway. Atmos. Environ. 99, 309–321 (2014).
Gupta, R. S., Zhang, X. Y., Sharp, L. K., Shannon, J. J. & Weiss, K. B. Geographic variability in childhood asthma prevalence in Chicago. J. Allergy Clin. Immunol. 121, 639–645 (2008).
Garg, R. K. A., Leighton, J., Perrin, M., Shah, M. Asthma Facts, Second Edition (New York City Department of Health and Mental Hygiene, New York City) https://www1.nyc.gov/assets/doh/downloads/pdf/asthma/facts.pdf.
Olmedo, O. et al. Neighborhood differences in exposure and sensitization to cockroach, mouse, dust mite, cat, and dog allergens in New York City. J. Allergy Clin. Immunol. 128, 284–292 e287 (2011).
Lee A., et al. Prenatal fine particulate exposure and early childhood asthma: effect of maternal stress and fetal sex. J. Allergy Clin. Immunol. 141, 1880–1886 (2017).
Shankardass, K. et al. Parental stress increases the effect of traffic-related air pollution on childhood asthma incidence. Proc. Natl Acad. Sci. USA 106, 12406–12411 (2009).
Chen, E., Schreier, H. M. C., Strunk, R. C. & Brauer, M. Chronic traffic-related air pollution and stress interact to predict biologic and clinical outcomes in asthma. Environ. Health Perspect. 116, 970–975 (2008).
Clougherty, J. E. et al. Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environ. Health Perspect. 115, 1140–1146 (2007).
Blanc, P. D. et al. Area-level socio-economic status and health status among adults with asthma and rhinitis. Eur. Respir. J. 27, 85–94 (2006).
O’Lenick, C. R. et al. Assessment of neighbourhood-level socioeconomic status as a modifier of air pollution-asthma associations among children in Atlanta. J. Epidemiol. Community Health 71, 129–136 (2017).
Williams, D. R., Sternthal, M. & Wright, R. J. Social determinants: taking the social context of asthma seriously. Pediatrics 123, S174–S184 (2009).
Cornell, A. G. et al. Domestic airborne black carbon and exhaled nitric oxide in children in NYC. J. Expo. Sci. Environ. Epidemiol. 22, 258–266 (2012).
Shmool, J. L., Kinnee, E., Sheffield, P. E. & Clougherty, J. E. Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York City. Environ. Res. 147, 108–114 (2016).
Maantay, J. Asthma and air pollution in the Bronx: methodological and data considerations in using GIS for environmental justice and health research. Health Place 13, 32–56 (2007).
Jung, K. H. et al. Effects of floor level and building type on residential levels of outdoor and indoor polycyclic aromatic hydrocarbons, black carbon, and particulate matter in New York City. Atmosphere 2, 96–109 (2011).
Tunnicliffe, W. S., Burge, P. S. & Ayres, J. G. Effect of domestic concentrations of nitrogen dioxide on airway responses to inhaled allergen in asthmatic patients. Lancet 344, 1733–1736 (1994).
Mainardi, T. R. et al. Exercise-induced wheeze, urgent medical visits, and neighborhood asthma prevalence. Pediatrics 131, e127–e135 (2013).
The New York City Community Air Survey. NYC Department of Health and Mental Hygiene (2017). https://www.1.nyc.gov/assets/doh/downloads/pdf/environmental/comm-air-survey-08-15.pdf
Krieger, J. & Higgins, D. L. Housing and health: time again for public health action. Am. J. Public Health 92, 758–768 (2002).
Acknowledgements
KL2TR001874; NIEHS (R01 ES014400, P30 ES09089); HUD Healthy Homes Technical Studies (NYHHU0003-11); Harold Amos Medical Faculty Development Award Program – Robert Wood Johnson Foundation.
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Lovinsky-Desir, S., Acosta, L.M., Rundle, A.G. et al. Air pollution, urgent asthma medical visits and the modifying effect of neighborhood asthma prevalence. Pediatr Res 85, 36–42 (2019). https://doi.org/10.1038/s41390-018-0189-3
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DOI: https://doi.org/10.1038/s41390-018-0189-3
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