The Journal of Allergy and Clinical Immunology
Volume 121, Issue 5 , Pages 1133-1139.e1, May 2008

Acute respiratory health effects of air pollution on children with asthma in US inner cities

  • George T. O'Connor, MD, MS

      Affiliations

    • Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Mass
    • Corresponding Author InformationReprint requests: George T. O'Connor, MD, MS, Boston University School of Medicine, Pulmonary Center, 715 Albany St, Room 304, Boston, MA 02118.
    • ,
  • Lucas Neas, DSc

      Affiliations

    • US Environmental Protection Agency, Research Triangle Park, NC
    • ,
  • Benjamin Vaughn, MS

      Affiliations

    • Rho Federal Systems Division, Inc, Chapel Hill, NC
    • ,
  • Meyer Kattan, MD

      Affiliations

    • Department of Pediatrics, Mount Sinai School of Medicine, New York, NY
    • ,
  • Herman Mitchell, PhD

      Affiliations

    • US Environmental Protection Agency, Research Triangle Park, NC
    • ,
  • Ellen F. Crain, MD

      Affiliations

    • Department of Pediatrics (Emergency Medicine), Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, NY
    • ,
  • Richard Evans III, MD

      Affiliations

    • Departments of Pediatrics and Medicine, Northwestern University Medical School, Chicago, Ill
    • Deceased.
    • ,
  • Rebecca Gruchalla, MD, PhD

      Affiliations

    • Departments of Medicine and Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Tex
    • ,
  • Wayne Morgan, MD

      Affiliations

    • Respiratory Sciences Center, University of Arizona College of Medicine, Tucson, Ariz
    • ,
  • James Stout, MD

      Affiliations

    • Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash
    • ,
  • G. Kenneth Adams, MD

      Affiliations

    • National Institute of Allergy and Infectious Diseases, Bethesda, Md
    • Retired.
    • ,
  • Morton Lippmann, PhD

      Affiliations

    • Department of Environmental Medicine, New York University School of Medicine, Tuxedo, NY

Received 22 August 2007; received in revised form 11 February 2008; accepted 11 February 2008. published online 14 April 2008.

Background

Children with asthma in inner-city communities may be particularly vulnerable to adverse effects of air pollution because of their airways disease and exposure to relatively high levels of motor vehicle emissions.

Objective

To investigate the association between fluctuations in outdoor air pollution and asthma morbidity among inner-city children with asthma.

Methods

We analyzed data from 861 children with persistent asthma in 7 US urban communities who performed 2-week periods of twice-daily pulmonary function testing every 6 months for 2 years. Asthma symptom data were collected every 2 months. Daily pollution measurements were obtained from the Aerometric Information Retrieval System. The relationship of lung function and symptoms to fluctuations in pollutant concentrations was examined by using mixed models.

Results

Almost all pollutant concentrations measured were below the National Ambient Air Quality Standards. In single-pollutant models, higher 5-day average concentrations of NO2, sulfur dioxide, and particles smaller than 2.5 μm were associated with significantly lower pulmonary function. Higher pollutant levels were independently associated with reduced lung function in a 3-pollutant model. Higher concentrations of NO2 and particles smaller than 2.5 μm were associated with asthma-related missed school days, and higher NO2 concentrations were associated with asthma symptoms.

Conclusion

Among inner-city children with asthma, short-term increases in air pollutant concentrations below the National Ambient Air Quality Standards were associated with adverse respiratory health effects. The associations with NO2 suggest that motor vehicle emissions may be causing excess morbidity in this population.

Key words: Nitrogen dioxide, ozone, sulfur dioxide, carbon monoxide, fine particle emissions, asthma in children

Abbreviations used: ICAS, Inner-City Asthma Study, NAAQS, National Ambient Air Quality Standards, PEFR, Peak expiratory flow rate, PM, Particulate matter, PM10, Particulate matter with aerodynamic diameter of less than 10 μm, PM2.5, Particulate matter with aerodynamic diameter of less than 2.5 μm

 

 Supported by grants AI-39769, AI-39900, AI-39902, AI-39789, AI-39901, AI-39761, AI-39785, and AI-39776 from the National Institute of Allergy and Infectious Diseases and the National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services; and by grant M01 RR00533 from the National Center for Research Resources, National Institutes of Health, Department of Health and Human Services; with partial support provided by the US Environmental Protection Agency through an interagency agreement with the National Institute of Allergy and Infectious Diseases. The manuscript has been subjected to agency review and approved for publication. The opinions expressed here do not necessarily reflect US Environmental Protection Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

 Disclosure of potential conflict of interest: R. Gruchalla has received research support from Novartis. W. Morgan has consulting arrangements with the Cystic Fibrosis Foundation; has patent licensing arrangements with the Childhood Asthma Research and Education Network and the National Heart, Lung, and Blood Institute; has received research support from the Cystic Fibrosis Foundation and the National Institute of Allergy and Infectious Diseases; and is on the advisory board for Genentech. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(08)00407-7

doi:10.1016/j.jaci.2008.02.020

The Journal of Allergy and Clinical Immunology
Volume 121, Issue 5 , Pages 1133-1139.e1, May 2008