Associations between weekly traffic-related air pollutants and pediatric asthma control in El Paso, Texas Öffentlichkeit

Abstract

Background- Previous studies have demonstrated harmful effects of traffic-related air pollution on lung function and respiratory symptoms among asthmatic children. However, no air pollution studies to date have estimated changes in lung function and symptoms concurrently using a validated, clinically relevant measure of asthma control.

Objective- To determine whether associations exist between traffic-related air pollution and asthma control in children with asthma living in El Paso, Texas, a city known for heavy traffic and high air pollution levels in the Paso del Norte region at the United States - Mexico border.

Methods- For 13 consecutive weeks, 36 children between the ages of 6 and 12 from two El Paso area elementary schools underwent weekly pulmonary function testing and reported symptoms medication use per the Asthma Control Questionnaire (ACQ). Preceding 96-hour integrated measurements of air pollutants, including fine and coarse particles, black carbon (BC), nitrogen dioxide (NO2), benzene, and toluene were measured outdoors at each school. Ozone (O3), temperature, and relative humidity levels were obtained from a regulatory monitoring site located between the two schools. Linear mixed effects models were used to examine associations between the 96-hour integrated pollutant levels and weekly ACQ scores.

Results- Positive, but not significant, associations were found between weekly ACQ scores and the preceding 96-hour average pollutant levels. Subgroup analysis revealed significant associations between ACQ scores and weekly benzene levels among subjects taking daily inhaled corticosteroids (ICS, p = 0.01) and borderline significant associations between scores and toluene levels in this group (p = 0.05). Among allergic subjects, levels of BC and NO2 were also associated with ACQ scores (p = 0.098 and p = 0.057 respectively).

Conclusion- ACQ scores were associated with weekly traffic-related pollutant concentrations among elementary school children with asthma, especially those in certain subgroups. The ACQ may serve as sensitive, clinically relevant tool to evaluate acute changes in pediatric asthma related to air pollution, but further studies are needed to validate the utility of this tool in this setting.

Table of Contents

Table of Contents
A. Introduction...1
B. Methods...4
C. Results...13
D. Discussion...19
E. Conclusion...25
F. Tables...26
G. Appendix

a. Tables and Figures...33
b. Literature Review...44

H. References...57

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Stichwort	air pollution, asthma, children, Asthma Control Questionnaire, longitudinal study, mixed model, random effects
Committee Chair / Thesis Advisor	Sarnat, Stefanie Ebelt, Emory University
Committee Members	Tolbert, Paige, Emory University
Partnering Agencies	State or local governmental agency (not a health department and not in Georgia)

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