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J Expo Sci Environ Epidemiol. 2016 Mar-Apr;26(2):180-8. doi: 10.1038/jes.2015.57. Epub 2015 Sep 9.

Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age.

Author information

1
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
2
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
3
School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.
4
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

Abstract

Previous studies have found strong associations between asthma morbidity and major ambient air pollutants. Relatively little research has been conducted to assess whether age is a factor conferring susceptibility to air pollution-related asthma morbidity. We investigated the short-term relationships between asthma emergency department (ED) visits and ambient ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and fine particulate matter (PM2.5) in Atlanta (1993-2009), Dallas (2006-2009), and St. Louis (2001-2007). City-specific daily time-series analyses were conducted to estimate associations by age group (0-4, 5-18, 19-39, 40-64, and 65+ years). Sub-analyses were performed stratified by race and sex. City-specific rate ratios (RRs) were combined by inverse-variance weighting to provide an overall association for each strata. The overall RRs differed across age groups, with associations for all pollutants consistently strongest for children aged 5-18 years. The patterns of association across age groups remained generally consistent when models were stratified by sex and race, although the strong observed associations among 5-18 year olds appeared to be partially driven by non-white and male patients. Our findings suggest that age is a susceptibility factor for asthma exacerbations in response to air pollution, with school-age children having the highest susceptibility.

PMID:
26350981
DOI:
10.1038/jes.2015.57
[Indexed for MEDLINE]

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