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Outdoor air pollution and health effects in urban children with moderate to severe asthma

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Abstract

Particulate matter less than 2.5 μm in diameter (PM2.5) is associated with asthma morbidity. Recent studies have begun examining the role of various constituents of PM2.5, their potential sources, and their effects on health. We examine their role in asthmatic children. Thirty-six children 6–14 years with moderate/severe asthma from inner city areas in New York City were studied for 2-week periods (summer and winter) using diaries and lung function. Outdoor data, including PM10, PM2.5, elements, elemental/organic carbon, and criteria gases (NO2, SO2, and O3) were collected at two sites. Odds ratios (ORs) relating daily pollutant concentrations to asthma indicators were calculated. During summer significant ORs>1 for symptom severity were obtained (O3, PM10, PM2.5, and S); after adjustment for O3, the ORs were no longer significant. During winter, Cu, Fe, Si, and Zn were significantly but negatively (ORs<1) associated with symptoms. Lag effects in winter suggested delayed effects (ORs>1) on symptoms (As, K, Pb, and V). Albuterol use increased during summer (O3, PM10, PM2.5, Na, and S); after adjustment for O3, only Na and S remained significant. Reduced pulmonary function was significantly associated with O3 and Cl. Components of PM2.5 are associated with asthma exacerbation in asthmatic children. Same-day pollutant associations with symptoms are seen in summer. In winter, our analysis suggests delayed adverse associations of PM2.5 components.

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Acknowledgments

This study was supported by the Electric Power Research Institute (EP-P15909/C7932). The authors would like to thank Tom Gentile, George O’Connor, and Lance Wallace, members of the CAPAS study scientific advisory committee, for their guidance in all phases of the study. Steve Ferguson and Mike Wolfson are also acknowledged for designing the air sampling monitors and conducting laboratory analyses. We thank Dr. Fred Moshary of CCNY for sharing his facilities. The authors would also like to thank all the individuals who participated in this study.

Conflict of interest

Dr. Rohr is employed by the Electric Power research Institute (EPRI) which is primarily supported by the electric industry in the US and abroad. EPRI is an independent 501(c)(3) organization that funds external research at a number of universities and institutes worldwide. Other authors declare no conflict of interest personal, financial or otherwise with the material presented in the manuscript.

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Author notes

  1. Avi Grunin

    Present address: Harvard Vanguard Medical Association, Boston, MA, USA

Authors and Affiliations

  1. Mount Sinai School of Medicine, 1 Gustave L. Levy Place 1232, New York, NY, 10029, USA

    E. Neil Schachter, Erin Moshier, James Godbold, Amit Nath & Avi Grunin

  2. Harvard School of Public Health, Boston, MA, USA

    Rima Habre, Brent Coull & Petros Koutrakis

  3. Electric Power Research Institute, Palo Alto, CA, USA

    Annette Rohr

  4. Columbia University Medical Center, New York, NY, USA

    Meyer Kattan

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  1. E. Neil Schachter
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Correspondence to E. Neil Schachter.

Electronic supplementary material

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Supplement Table 1a

Correlation coefficients matrix for pollutants and weather parameters (WINTER). (DOCX 26 kb)

Supplement Table 1b

Correlation coefficients matrix for pollutants and weather parameters (SUMMER). (DOCX 29 kb)

Supplement Table 2

P-values testing for Proportional Odds Ratios (OR) for total symptom score (cough and wheeze) per interquartile range increase in daily outdoor pollutant levels. All ORs were adjusted for gender, Hispanic ethnicity, daily ambient maximum relative humidity, average temperature and same day ozone. (DOC 73 kb)

Supplement Table 3

Proportional Odds Ratios (OR) for more albuterol puffs per interquartile range increase in daily outdoor pollutant levels on all seven lag days. All ORs were adjusted for gender, Hispanic ethnicity, daily ambient maximum relative humidity, average temperature and same day Ozone. (DOCX 53 kb)

Supplement Table 4

Proportional Odds Ratios (OR) for lung function AM and PM (PEF% of predicted and daily lability) per interquartile range increase in daily outdoor pollutant levels on same day and lag day 4. All ORs were adjusted for gender, Hispanic ethnicity, daily ambient maximum relative humidity, average temperature. We show ORs both adjusted and unadjusted for same day Ozone. (DOCX 43 kb)

Supplement Figure 1a

Forest plots for symptoms and ambient pollutants (PM2.5 and PM10 and pollutants with borderline significance [0.1>p>0.05] winter adverse ORs). (DOC 1367 kb)

Supplement Figure 1b

Forest plots of pollutants demonstrating non-significant delayed adverse symptom effects in winter. Seven day lags illustrated for Summer and Winter. All ORs were adjusted for gender, Hispanic ethnicity, daily ambient maximum relative humidity, average temperature and Ozone. (DOC 29 kb)

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Schachter, E.N., Moshier, E., Habre, R. et al. Outdoor air pollution and health effects in urban children with moderate to severe asthma. Air Qual Atmos Health 9, 251–263 (2016). https://doi.org/10.1007/s11869-015-0335-6

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