Skip to main content

Advertisement

SpringerLink
Log in

Ambient air pollution and emergency department visits for asthma in Erie County, New York 2007–2012

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

8% of the US population has asthma. Air pollution is linked to exacerbation in susceptible individuals. The objective was to identify air pollutants that increased the risk of asthma emergency department visits during a time wherein a polluting factory was criminally convicted, changing local air pollutant levels.

Methods

An ecological time-series design used a daily count of asthma emergency visits from 2007 to 2012 as the dependent variable. Independent variables air pollutants (NO2, PM2.5 CO, and O3), controlling for meteorological conditions, were analyzed using time-series and Poisson GLM models.

Results

76,651 emergency asthma visits were included with an average of 35 visits per day (SD = 9.2, range 11–80) in a stationary time series. Increased visit volume in fall and spring had no associations to the air pollutants. Associations between individual air pollutants occurred in otherwise low-volume months for asthma emergency visits. The strongest relationship was an 11.6% increase in the asthma emergency visit rate during the month of June. In monthly groupings that removed most of the autumn and spring months, O3, PM2.5, CO, and NO2 were associated with 5, 4, 2, and 2% increases in asthma emergency visits, respectively. CO was the only pollutant with a negative association with asthma emergency visits, occurring in the month of April.

Conclusions

Pollutants NO2, PM2.5 CO, and O3 were associated with increased emergency asthma visits in some, but not all months of the year. Air pollution’s impact on asthma emergencies may be masked by other, more influential seasonal triggers, such as infections or allergies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • 42 USC (1977) 7401-7671 Clean Air Act

  • Alhanti BA, Chang HH, Winquist A, Mulholland JA, Darrow LA, Sarnat SE (2016) Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age. J Expo Sci Environ Epidemiol 26(2):180–188. doi:10.1038/jes.2015.57

    Article  CAS  Google Scholar 

  • Anderson HR, Favarato G, Atkinson RW (2013) Long-term exposure to air pollution and the incidence of asthma: meta-analysis of cohort studies. Air Qual Atmos Health 6(1):47–56

    Article  CAS  Google Scholar 

  • Choi M, Curriero FC, Johantgen M, Mills ME, Sattler B, Lipscomb J (2011) Association between ozone and emergency department visits: an ecological study. Int J Environ Health Res 21(3):201–221

    Article  CAS  Google Scholar 

  • Cirera L et al (2012) Daily effects of air pollutants and pollen types on asthma and COPD hospital emergency visits in the industrial and Mediterranean Spanish city of Cartagena. Allergol Immunopathol 40(4):231–237

    Article  CAS  Google Scholar 

  • Civic Impulse (2017) S. 1630—101st Congress: Clean Air Act Amendments of 1990

  • Cook AG, deVos AJ, Pereira G, Jardine A, Weinstein P (2011) Use of a total traffic count metric to investigate the impact of roadways on asthma severity: a case-control study. Environ Health A Global Access Sci Source 10:52

    Google Scholar 

  • Cromar KR, Gladson LA, Perlmutt LD, Ghazipura M, Ewart GW (2016) American Thoracic Society and Marron Institute Report. Estimated excess morbidity and mortality caused by air pollution above American thoracic society-recommended standards, 2011–2013. Ann Am Thorac Soc 13(8):1195–1201. doi:10.1513/AnnalsATS.201602-103AR

    Article  Google Scholar 

  • D’Amato G et al (2016) Climate change and air pollution: effects on respiratory allergy. Allergy Asthma Immunol Res 8(5):391–395. doi:10.4168/aair.2016.8.5.391

    Article  CAS  Google Scholar 

  • Darrow LA et al (2011) The use of alternative pollutant metrics in time-series studies of ambient air pollution and respiratory emergency department visits. J Expo Sci Environ Epidemiol 21(1):10–19. doi:10.1038/jes.2009.49

    Article  CAS  Google Scholar 

  • Darrow LA, Klein M, Flanders WD, Mulholland JA, Tolbert PE, Strickland MJ (2014) Air pollution and acute respiratory infections among children 0–4 years of age: an 18-year time-series study. Am J Epidemiol 180(10):968–977. doi:10.1093/aje/kwu234

    Article  Google Scholar 

  • Delfino RJ, Wu J, Tjoa T, Gullesserian SK, Nickerson B, Gillen DL (2014) Asthma morbidity and ambient air pollution: effect modification by residential traffic-related air pollution. Epidemiology 25(1):48–57. doi:10.1097/ede.0000000000000016

    Article  Google Scholar 

  • Di Q et al (2017) Air pollution and mortality in the medicare population. N Engl J Med 376(26):2513–2522. doi:10.1056/NEJMoa1702747

    Article  CAS  Google Scholar 

  • United States Environmental Protection Agency (2017). https://aqs.epa.gov/aqsweb/documents/data_mart_welcome.html. Accessed 05 May 2017

  • Galan I, Tobias A, Banegas JR, Aranguez E (2003) Short-term effects of air pollution on daily asthma emergency room admissions. Eur Respir J 22(5):802–808

    Article  CAS  Google Scholar 

  • Gass K et al (2015) Associations between ambient air pollutant mixtures and pediatric asthma emergency department visits in three cities: a classification and regression tree approach. Environ Health 14:58. doi:10.1186/s12940-015-0044-5

    Article  CAS  Google Scholar 

  • Gauderman WJ et al (2015) Association of improved air quality with lung development in children. N Engl J Med 372(10):905–913. doi:10.1056/NEJMoa1414123

    Article  CAS  Google Scholar 

  • Guarnieri M, Balmes JR (2014) Outdoor air pollution and asthma. Lancet 383(9928):1581–1592. doi:10.1016/s0140-6736(14)60617-6

    Article  CAS  Google Scholar 

  • Halonen JI, Lanki T, Tiittanen P, Niemi JV, Loh M, Pekkanen J (2010) Ozone and cause-specific cardiorespiratory morbidity and mortality. J Epidemiol Community Health 64(9):814–820. doi:10.1136/jech.2009.087106

    Article  Google Scholar 

  • Johnston NW, Sears MR (2006) Asthma exacerbations. 1: Epidemiology. Thorax 61(8):722–728. doi:10.1136/thx.2005.045161

    Article  CAS  Google Scholar 

  • Johnston NW, Johnston SL, Norman GR, Dai J, Sears MR (2006) The September epidemic of asthma hospitalization: school children as disease vectors. J Allergy Clin Immunol 117(3):557–562. doi:10.1016/j.jaci.2005.11.034

    Article  Google Scholar 

  • Kloog I, Nordio F, Zanobetti A, Coull BA, Koutrakis P, Schwartz JD (2014) Short term effects of particle exposure on hospital admissions in the Mid-Atlantic states: a population estimate. PLoS One 9(2):e88578. doi:10.1371/journal.pone.0088578

    Article  CAS  Google Scholar 

  • Kousha T, Castner J (2016) the air quality health index and emergency department visits for otitis media. J Nurs Scholarsh 48(2):163–171. doi:10.1111/jnu.12195

    Article  Google Scholar 

  • Kousha T, Rowe BH (2014) Ambient ozone and emergency department visits due to lower respiratory condition. Int J Occup Med Environ Health 27(1):50–59. doi:10.2478/s13382-014-0229-0

    Article  Google Scholar 

  • Lavigne E, Villeneuve PJ, Cakmak S (2012) Air pollution and emergency department visits for asthma in Windsor, Canada. Can J Public Health 103(1):4–8

    Article  Google Scholar 

  • Lim SS et al (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2224–2260. doi:10.1016/s0140-6736(12)61766-8

    Article  Google Scholar 

  • Linaker CH et al (2000) Personal exposure to nitrogen dioxide and risk of airflow obstruction in asthmatic children with upper respiratory infection. Thorax 55(11):930–933

    Article  CAS  Google Scholar 

  • Malig BJ et al (2016) A time-stratified case-crossover study of ambient ozone exposure and emergency department visits for specific respiratory diagnoses in California (2005–2008). Environ Health Perspect 124(6):745–753. doi:10.1289/ehp.1409495

    Article  CAS  Google Scholar 

  • Masjedi MR et al (2003) The effects of air pollution on acute respiratory conditions. Respirology 8(2):213–230

    Article  Google Scholar 

  • Masoli M, Fabian D, Holt S, Beasley R (2004) The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 59(5):469–478. doi:10.1111/j.1398-9995.2004.00526.x

    Article  Google Scholar 

  • Moineddin R, Nie JX, Domb G, Leong AM, Upshur RE (2008) Seasonality of primary care utilization for respiratory diseases in Ontario: a time-series analysis. BMC Health Serv Res 8:160. doi:10.1186/1472-6963-8-160

    Article  Google Scholar 

  • New York State Department of Environmental Conservation (2009) Tonawanda community air quality study—June 2009. https://www.dec.ny.gov/chemical/59464.html. Accessed 5 May 2015

  • New York State Department of Health (2015) Statewide Planning and Research Cooperative System (SPARCS)

  • New York State Department of Environmental Conservation (2016) Tonawanda community air quality study—update, December 2016. https://www.dec.ny.gov/chemical/59464.html. Accessed 13 Oct 2017

  • Paulu C, Smith AE (2008) Tracking associations between ambient ozone and asthma-related emergency department visits using case-crossover analysis. J Public Health Manag Pract 14(6):581–591. doi:10.1097/01.PHH.0000338371.53242.0e

    Article  Google Scholar 

  • Peel JL et al (2005) Ambient air pollution and respiratory emergency department visits. Epidemiology 16(2):164–174

    Article  Google Scholar 

  • Sacks JD, Rappold AG, Davis JA Jr, Richardson DB, Waller AE, Luben TJ (2014) Influence of urbanicity and county characteristics on the association between ozone and asthma emergency department visits in North Carolina. Environ Health Perspect 122(5):506–512. doi:10.1289/ehp.1306940

    Article  CAS  Google Scholar 

  • Stafoggia M et al (2013) Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project. Environ Health Perspect 121(9):1026–1033. doi:10.1289/ehp.1206151

    Article  CAS  Google Scholar 

  • Stieb DM, Szyszkowicz M, Rowe BH, Leech JA (2009) Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis. Environ Health 8:25. doi:10.1186/1476-069x-8-25

    Article  Google Scholar 

  • Strickland MJ et al (2010) Short-term associations between ambient air pollutants and pediatric asthma emergency department visits. Am J Respir Crit Care Med 182(3):307–316. doi:10.1164/rccm.200908-1201OC

    Article  Google Scholar 

  • Strickland MJ et al (2011) Implications of different approaches for characterizing ambient air pollutant concentrations within the urban airshed for time-series studies and health benefits analyses. Environ Health 10:36. doi:10.1186/1476-069x-10-36

    Article  Google Scholar 

  • Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y (2016) Pediatric emergency visits and short-term changes in PM2.5 concentrations in the U.S. State of Georgia. Environ Health Perspect 124(5):690–696. doi:10.1289/ehp.1509856

    Article  CAS  Google Scholar 

  • Szyszkowicz M, Kousha T (2014) Emergency department visits for asthma in relation to the Air Quality Health Index: a case-crossover study in Windsor, Canada. Can J Public Health 105(5):e336–e341

    Article  Google Scholar 

  • Tetreault LF et al (2016) Severe and moderate asthma exacerbations in asthmatic children and exposure to ambient air pollutants. Int J Environ Res Public Health. doi:10.3390/ijerph13080771

    Article  Google Scholar 

  • Tolbert PE et al (2000) Air quality and pediatric emergency room visits for asthma in Atlanta, Georgia, USA. Am J Epidemiol 151(8):798–810

    Article  CAS  Google Scholar 

  • Toxic Release Inventory Explorer (2015) https://iaspub.epa.gov/triexplorer/tri_release.chemical. Accessed 5 May 2015

  • United States v Tonawanda Coke Corporation (2013) W.D.N.Y 10-CR-219S

  • Woodruff TJ et al (2009) Methodological issues in studies of air pollution and reproductive health. Environ Res 109(3):311–320. doi:10.1016/j.envres.2008.12.012

    Article  CAS  Google Scholar 

  • Wright RJ et al (2008) Transdisciplinary research strategies for understanding socially patterned disease: the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project as a case study. Cien Saude Colet 13(6):1729–1742

    Article  Google Scholar 

  • Zahran H, Bailey C, Garbe P (2011) Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001–2009. MMWR Morb Mortal Wkly Rep 60(17):547–552

    Google Scholar 

Download references

Acknowledgements

This study was funded by the University at Buffalo’s Civic Engagement and Public Policy Dissemination Fellowship grant and the Patricia H. Garman Behavioral Health Nursing Endowment at the University at Buffalo School of Nursing. This study was performed in partial fulfillment of Dr. Caster’s role as lead investigator, with anticipated support from, the Environmental Health Study of Western New York (also documented as The Tonawanda Health Study: An Epidemiologic Study of Health Effects and Coke Oven Emissions from Tonawanda Coke). The authors gratefully acknowledge our community partners, IT support, and Drs. Tarunraj Singh and Robert Baier, as well as students and research assistants Souransu Nandi, Ziqiang Chen, Wolf Wackeroth, Nan Nan, Harish Mangalampalli and Angad Gadre.

Author information

Authors and Affiliations

  1. University at Buffalo, Buffalo, NY, USA

    Jessica Castner

  2. Heilbrunn Family Center for Research Nursing Scholar, Rockefeller University, New York, NY, USA

    Jessica Castner

  3. Medpace, Cincinnati, OH, USA

    Lingfei Guo

  4. Department of Economics, College of Arts and Sciences, University at Buffalo, Buffalo, NY, USA

    Yong Yin

Authors
  1. Jessica Castner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lingfei Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yong Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JC and YY contributed to the concept, design and analysis of the data. LG contributed to the analysis and interpretation of the data. JC drafted the paper and all authors contributed to the revision and final approval.

Corresponding author

Correspondence to Jessica Castner.

Ethics declarations

Ethical approval

Relevant ethical approval was obtained from the New York State Data Protection Review Board (#1403-05) and the University at Buffalo’s Institutional Review Board.

Conflict of interest

Dr. Yin and Mr. Guo declare no conflict of interest. Dr. Castner’s research has been funded by grants from The Rockefeller University Heilbrunn Family Center for Nursing Research, NSF (#1737617, #1645090), The Ohio State University, University at Buffalo, and had been committed support by the University at Buffalo through NIH (#1U54TR001358). Dr. Castner has received support from the Emergency Nursing Association/Journal of Emergency Nursing for teaching, speaking honoraria, and editor/editorial board travel. Dr. Castner has had a research/data analysis consulting relationship with the Harvard T. H. Chan School of Public Health, American Lung Association, and hospitals in the region of study, with additional funding/consulting disclosures which are unlikely to be perceived as a conflict of interest available on request.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 186 kb)

Supplementary material 2 (DOCX 1096 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Castner, J., Guo, L. & Yin, Y. Ambient air pollution and emergency department visits for asthma in Erie County, New York 2007–2012. Int Arch Occup Environ Health 91, 205–214 (2018). https://doi.org/10.1007/s00420-017-1270-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-017-1270-7

Keywords

Search

Navigation