Examining associations between childhood asthma and traffic flow using a geographic information system.

English, Paul; Neutra, Raymond; Scalf, Russell; Sullivan, Moira; Waller, Lance A.; Zhu, Li

doi:10.1289/ehp.99107761

Cited by 245 publications

(164 citation statements)

References 23 publications

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“…There was some evidence that infants and girls were at highest risk. These results are consistent with those of a cross-sectional study 26 and 2 case-control studies 27,28 showing increased risk of asthma hospitalizations or other medical care visits with increasing home traffic density indices. These results are also consistent with those of a longitudinal analysis of recurrent respiratory hospital encounters using traffic indices, 20 but associations in that study were not significant for patients with a primary diagnosis of asthma.…”

Section: Overview Of Findings and Implicationssupporting

confidence: 91%

Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home

Delfino

Chang

et al. 2009

Annals of Allergy, Asthma & Immunology

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Background: Aggregate hospital encounters for asthma (admissions or emergency department visits) have been associated with daily regional air pollution. There are fewer data on relationships between repeated hospital encounters and traffic-related air pollution near the home.Objective: To estimate the association of local traffic-generated air pollution with repeated hospital encounters for asthma in children.Methods: Hospital records for 2,768 children aged 0 to 18 years (697 of whom had Ն2 encounters) were obtained for a catchment area of 2 hospitals in northern Orange County, California. Residential addresses were geocoded. A line source dispersion model was used to estimate individual seasonal exposures to local traffic-generated pollutants (nitrogen oxides and carbon monoxide) longitudinally beginning with the first hospital encounter. Recurrent proportional hazards analysis was used to estimate risk of exposure to air pollution adjusting for sex, age, health insurance, census-derived poverty, race/ethnicity, residence distance to hospital, and season. The adjustment variables and census-derived median household income were tested for effect modification.Results: Adjusted hazard ratios for interquartile range increases in nitrogen oxides (4.00 ppb) and carbon monoxide (0.056 ppm) were 1.10 (95% confidence interval, 1.03-1.16) and 1.07 (1.01-1.14), respectively. Associations were strongest for girls and infants but were not significantly different from other groups. Stronger associations in children from higher-income block groups (P Ͻ .09 for trend) may have been due to more accurate data.Conclusions: Associations for repeated hospital encounters suggest that locally generated air pollution near the home affects asthma severity in children. Risk may begin during infancy and continue in later childhood, when asthma diagnoses are clearer.

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Section: Overview Of Findings and Implicationssupporting

confidence: 91%

Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home

Delfino

Chang

et al. 2009

Annals of Allergy, Asthma & Immunology

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“…One found that trafficrelated pollution is associated with respiratory symptoms in children (Kim et al, 2004). The other found no increase in asthma prevalence related to residence proximity to high traffic roads in a cohort of low income children, although they reported an increase in medical visits for asthma by traffic-exposed children (English et al, 1999).…”

Section: Discussionmentioning

confidence: 91%

An investigation of the association between traffic exposure and the diagnosis of asthma in children

Gordian

Haneuse

Wakefield

2005

J Expo Sci Environ Epidemiol

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This study investigated whether proximity to traffic at residence location is associated with being diagnosed with asthma as a young child. A survey of parents of children (aged 5-7) in kindergarten and first-grade in 13 schools was completed in Anchorage, Alaska, and Geographical Information System (GIS) mapping was used to obtain an exposure measure based on traffic density within 100 m of the cross streets closest to the child's residence. Using the range of observed exposure values, a score of low, medium or high traffic exposure was assigned to each child. After controlling for individual level confounders, relative to the low referent group, relative risks (95% confidence intervals) of 1.40 (0.77, 2.55) and 2.83 (1.23,6.51) were obtained in the medium and high exposure groups, respectively. For the null hypothesis of no difference in risk, a significance level of 0.056 was obtained, which suggests that further investigation would be worthwhile. Children without a family history of asthma were more likely to have an asthma diagnosis if they resided in a high traffic area than children who had one or more parents with asthma. The relative risk for children without a family history of asthma is 2.43 (1.12, 5.28) for medium exposure and 5.43 (2.08, 13.74) for high exposure. For children with a family history of asthma, the relative risk is 0.66 (0.25, 1.74) for medium exposure and 0.67 (0.12, 3.69) for high exposure. The P-value for the overall ''exposure-effect'' (i.e. both main effects AND interaction terms) is 0.0097.

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“…For studies in the US, it has been reported that automated address matching was poor for rural areas (match rate of 20 -30% ) and much higher (98% ) for the largest urbanized county in North Carolina (Vine et al, 1997 ). A study in San Diego County reported a 85% address match, with missing data due in part to listing of PO boxes and incomplete addresses (English et al, 1999 ) .…”

Section: Application Of Gismentioning

confidence: 99%

“…In a study in San Diego, traffic flow in buffers of 550 ft was used to characterized local scale exposures (English et al, 1999) .…”

Section: Local Scalementioning

confidence: 99%

Estimation of long-term average exposure to outdoor air pollution for a cohort study on mortality

Hoek

Fischer

Brandt

et al. 2001

J Expo Sci Environ Epidemiol

138

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Recent prospective cohort studies have suggested that long -term exposure to low levels of particulate matter ( PM ) air pollution is associated with increased mortality due to, especially, cardio -pulmonary disease. Exposure to ambient air pollution was estimated mostly as city average concentrations, assuming homogenous exposure within the city. We used an ongoing cohort study -The Netherlands Cohort Study ( NLCS ) on diet and cancer -to investigate the relationship between traffic -related air pollution and mortality. The baseline data collection took place in 1986. A study was conducted to develop methods for exposure assessment and evaluate the contrast in exposure to air pollution within the cohort. Assessment of long -term exposure to two traffic -related air pollutants, Black Smoke ( BS ) and Nitrogen Dioxide ( NO 2 ) , consisted of separate estimation of regional background, urban background, and local traffic contributions at the home address. Interpolation of concentration data from a routine monitoring network was used to estimate the regional background concentration. A regression model relating degree of urbanization to air pollution was used to allow for differences between different towns / neighborhoods of cities. Distance to major roads was calculated to characterize local traffic contributions, using a Geographic Information System ( GIS ) . Interpolation resulted in reasonably precise regional background estimation when distant sites were not used and distance squared was used as the weight. Cross -validation showed that prediction errors were about 15% of the range in regional background concentration. Urban and local scales contributed significantly to the contrast within the cohort. Prediction errors for estimating the urban background were about 25% of the range in background concentrations. When the developed model was applied to the study cohort, there was substantial contrast in estimated exposure to BS and NO 2 . About 90% of the study population lived 10 years or more at its 1986 home address -supporting the use of the estimated concentration at the 1986 address as a relevant exposure variable.

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Examining associations between childhood asthma and traffic flow using a geographic information system.

Cited by 245 publications

References 23 publications

Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home

Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home

An investigation of the association between traffic exposure and the diagnosis of asthma in children

Estimation of long-term average exposure to outdoor air pollution for a cohort study on mortality

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