Association between Ozone and Hospitalization for Acute Respiratory Diseases in Children Less than 2 Years of Age

Burnett, Richard T.; Smith‐Doiron, Marc; Stieb, Dave; Raizenne, Mark; Brook, Jeffrey R.; Dales, Robert; Leech, Judy; Cakmak, Sabit; Krewski, Daniel

doi:10.1093/aje/153.5.444

Cited by 137 publications

(75 citation statements)

References 37 publications

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“…Third, we have access to reliable measurements of daily SO 2 , NO 2 , CO, O 3 , and PM 2.5 levels that have been used in previous studies of the association between air pollution and morbidity (Burnett et al, 1997(Burnett et al, , 2001Yang et al, 2003) and mortality (Burnett et al, 2000) by members of our research team. Unfortunately, information on some known risk factors for fetal growth development, such as maternal race, education, cigarette smoking, caloric intake, alcohol consumption, paternal weight and height, and socioeconomic status was not available.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has demonstrated consistent associations between ambient air pollution and adverse health effects such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases (Dockery et al, 1993;Burnett et al, 1997Burnett et al, , 2001. Recent studies have further demonstrated association between ambient air pollution and adverse pregnancy outcomes, including low birth weight, preterm birth, IUGR and birth defects in China (Xu et al, 1995;Wang et al, 1997), the Czech Republic (Bobak, 2000), the United States (Ritz and Yu, 1999;Ritz et al, 2000Ritz et al, , 2002Parker et al, 2005), and Korea (Lee et al, 2003).…”

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction

Liu

Krewski

Shi

et al. 2006

J Expo Sci Environ Epidemiol

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109

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Previous research demonstrated consistent associations between ambient air pollution and emergency room visits, hospitalizations, and mortality. Effect of air pollution on perinatal outcomes has recently drawn more attention. We examined the association between intrauterine growth restriction (IUGR) among singleton term live births and sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide (CO), ozone (O 3 ), and fine particles (PM 2.5 ) present in ambient air in the Canadian cities of Calgary, Edmonton, and Montreal for the period 1985-2000. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for IUGR, based on average daily levels of individual pollutants over each month and trimester of pregnancy after adjustment for maternal age, parity, infant gender, season, and city of residence. A 1 ppm increase in CO was associated with an increased risk of IUGR in the first (OR ¼ 1.18; 95% CI 1.14-1.23), second (OR ¼ 1.15; 95% CI 1.10-1.19) and third (OR ¼ 1.19; 95% CI 1.14-1.24) trimesters of pregnancy, respectively. A 20 ppb increase in NO 2 (OR ¼ 1.16; 95% CI 1.09-1.24; OR ¼ 1.14; 95% CI 1.06-1.21; and OR ¼ 1.16; 95% CI 1.09-1.24 in the first, second, and third trimesters) and a 10 mg/m 3 increase in PM 2.5 (OR ¼ 1.07; 95% CI 1.03-1.10; OR ¼ 1.06; 95% CI 1.03-1.10; and OR ¼ 1.06; 95% CI 1.03-1.10) were also associated with an increased risk of IUGR. Consistent results were found when ORs were calculated by month rather than trimester of pregnancy. Our findings add to the emerging body of evidence that exposure to relatively low levels of ambient air pollutants in urban areas during pregnancy is associated with adverse effects on fetal growth.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction

Liu

Krewski

Shi

et al. 2006

J Expo Sci Environ Epidemiol

Self Cite

109

View full text Add to dashboard Cite

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“…The estimated effect increased to 1.9% per 10 ppb when a 5-day cumulative average of exposure was used. Burnett et al 28 investigated respiratory hospitalizations in children under age 2, finding an impact that corresponds to a 6.6% increase per 10-ppb increase in 1-hr daily maximum O 3 . For the assessment of benefits, a 50% weight was placed on the estimate of 1.7% per 10 ppb and a 25% weight was placed on the lower and upper confidence limits.…”

Section: Cr Functionsmentioning

confidence: 99%

The Health Benefits of Reduced Tropospheric Ozone in California

Ostro

Tran

Levy³

2006

Journal of the Air & Waste Management Association

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Californians are exposed daily to concentrations of ozone (O 3 ) that are among the highest in the United States. Recently, the state adopted a new 8-hr ambient standard of 0.070 ppm, more stringent than the current federal standard. The new standard is based on controlled human studies and on dozens of epidemiologic studies reporting associations between O 3 at current ambient levels and a wide range of adverse health outcomes. Clearly, the new O 3 standards will require further reductions in the precursor pollutants and additional expenditures for pollution control. Therefore, it is important to quantify the incremental health benefits of moving from current conditions to the new California standard. In this paper, a standard methodology is applied to quantify the health benefits associated with O 3 concentration reductions in California. O 3 concentration reductions are estimated using ambient monitoring data and a proportional rollback approach in which changes are specific to each air basin, and control strategies may impact concentrations both below and above the standard. Health impacts are based on published epidemiologic studies, including O 3 -related mortality and morbidity, and economic values are assigned to these outcomes based on willingness-to-pay and cost-of-illness studies. Central estimates of this research indicate that attaining the California 8-hr standard, relative to current concentrations, would result in annual reductions of 630 cases of premature mortality, 4200 respiratory hospital admissions, 660 pediatric emergency room visits for asthma, 4.7 million days of school loss, and 3.1 million minor restricted activity days, with a median estimated economic value of $4.5 billion. Sensitivity analyses indicate that these findings are robust with respect to exposure assessment methods but are influenced by assumptions about the slope of the concentration-response function in threshold models and the magnitude of the O 3 -mortality relationship. Although uncertainties exist for several components of the methodology, these results indicate that the benefits of reducing O 3 to the California standard may be substantial and that further research on the shape of the O 3 -mortality concentration-response function and economic value of O 3 -related mortality would best reduce these uncertainties.

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“…[3][4][5][6] Most previous studies of hospital outcomes associated with air pollution exposures usually either aggregated respiratory infections with other respiratory conditions such as asthma and chronic obstructive pulmonary disease into a single study group or focused on the air pollution effect on respiratory infection in all ages, 7 elderly, 8 or very young children (aged 0 -2 years). 9 Children generally breathe more rapidly than adults, they may have more exposure to air pollutants per kilogram of body weight, and respiratory infections are generally more common in boys than in girls. 10 So far it has not been clear whether there are gender differences in effects of ambient air pollutants on respiratory infections in children.…”

mentioning

confidence: 99%

Coarse Particulate Matter and Hospitalization for Respiratory Infections in Children Younger Than 15 Years in Toronto: A Case-Crossover Analysis

2005

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ABSTRACT. Objectives. The purpose of this study was to examine the association between ambient air pollution and hospitalization for respiratory infections among children who were younger than 15 years in Toronto during a 4-year period (1998 -2001).Methods. Exposures averaged during periods that varied from 1 to 7 days were used to assess the effects of air pollutants, including thoracic particulate matter (PM 10 ), fine (PM 2.5 ) and coarse (PM 10 -2.5 ) particulate matter, carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ), on hospitalization for respiratory infections. A case-crossover design was used to calculate odds ratios for the hospitalization adjusted for daily weather conditions with an incremented exposure corresponding to the interquartile range in air pollution exposures.Results. When particulate matter and gaseous pollutants were mutually taken into account, the effect remained pronounced for PM 10 -2.5 in both boys and girls. The adjusted odds ratio for 6-day average exposure to PM 10 -2.5 with an increment of 6.5 g/m 3 was 1.15 (95% confidence interval: 1.02-1.30) for boys and 1.18 (95% confidence interval: 1.01-1.36) for girls. The effect also remained for PM 10 in boys and for NO 2 in girls. PM 2.5 , CO, SO 2 , and O 3 showed no significant effects on hospitalization for respiratory infection in both genders when other pollutants were taken into consideration.Conclusion. Our study suggested a detrimental effect of relatively low levels of ambient particulate matter and gaseous pollutants, especially coarse particulate matter and NO 2 , on hospitalization for respiratory infections in children. Pediatrics 2005;116:e235-e240. URL: www. pediatrics.org/cgi/doi/10.1542/peds.2004-2012; air pollution, coarse particulate matter, gaseous pollutants, hospitalization for respiratory infection, case-crossover analysis, risk assessment.ABBREVIATIONS. CO, carbon monoxide; SO 2 , sulfur dioxide; NO 2 , nitrogen dioxide; O 3 , ozone; PM 10 , thoracic particulate matter Ͻ10 m in aerodynamic diameter; PM 2.5 , fine particulate matter Ͻ2.5 m in aerodynamic diameter; TEOM, tapered element oscillating microbalance; PM 10 -2.5 , coarse particulate matter between 2.5 and 10 m in aerodynamic diameter; OR, odds ratio; CI, confidence interval; TSP, total suspended particles. L ower respiratory infection is a main cause of mortality and morbidity in children in developing countries. Morbidity from childhood respiratory infections is also high in developed countries. 1 Although respiratory infections in children are usually nonfatal in developed countries, they heavily burden the health care systems. 2 Additional progress in preventing the diseases will have a significant impact on children's health. 1 Although there is abundant evidence linking outdoor air pollution with respiratory symptoms, reduced lung function, bronchial reactivity, and asthma, the relationship of hospital morbidity for respiratory infections to a relatively low level of exposure to air pollution in children has...

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Association between Ozone and Hospitalization for Acute Respiratory Diseases in Children Less than 2 Years of Age

Cited by 137 publications

References 37 publications

Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction

Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction

The Health Benefits of Reduced Tropospheric Ozone in California

Coarse Particulate Matter and Hospitalization for Respiratory Infections in Children Younger Than 15 Years in Toronto: A Case-Crossover Analysis

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