Biological Markers of Asthma and Roadway Proximity Open Access

Brown, Meredith Suzanne (2011)

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Biological Markers of Asthma and Roadway Proximity
By Meredith Suzanne Brown
Asthma is the most common chronic pediatric disease worldwide. Exposure to traffic-
related air pollutants has been associated with adverse respiratory symptoms and several studies
have shown that living near major roadways increases qualitative markers of asthma severity.
My thesis seeks to 1) determine whether actual residential distance to a major roadway is
associated with quantitative measures such as increased airway or systemic oxidative stress in
asthmatic children and 2) determine whether residential distance to a major roadway and markers
of oxidative stress are associated with clinical features of asthma severity in children. These
questions were addressed through ArcGIS, a mapping tool used to measure residential distance
from a major roadway, and database analysis of clinical and biological markers of asthma
severity. Overall, patients who lived less than 300 meters from a major roadway experienced
increased markers of systemic oxidative stress as measured by plasma cysteine/cystine, increased
clinical markers of asthma severity as measured by wheeze incidence and β-agonsist use,
decreased lung function and greater healthcare utilization compared to patients living greater
than 300 meters from a major roadway. This suggests that traffic related air pollution might be a
significant contributor to increased asthma symptoms and severity.

Biological Markers of Asthma and Roadway Proximity
Meredith Suzanne Brown
Bachelor of Science
Emory University
Thesis Committee Chair: Dr. Stefanie Sarnat, Sc.D.
An abstract of
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Public Health
in Environmental Health

Table of Contents

Table of Contents

  1. Introduction 1
  2. Methods
    1. Subject characterization and Health Outcome Data 6
    2. Proximity to Roadway Data 8
    3. Epidemiological Analysis 9
  3. Results
    1. Study Population Demographics 10
    2. Relationship to Markers of Oxidative Stress 12
    3. Relationship to Clinical Asthma Features 13

i. Relationship to Persistence of Clinical Asthma Symptoms 13

ii. Relationship To Lung Function 14

    1. Relationship to Healthcare Utilization 15
  1. Discussion 16
  2. Appendix
    1. Tables

i. Table 1. Study Population Demographics 21

ii. Table 2. Biological Markers of Oxidative Stress Correlations 22

iii. Table 3. Clinical Markers of Asthma Severity Outcomes 23

  1. Image and Figure Legends 24
  2. Images and Figures

i. Image 1: Patient's address and major roadways (GIS) 28

ii. Figure 1: Cysteine/cystine redox potential 29

iii. Figure 2: Daily β-agonists use 30

iv. Figure 3: Wheezing at least twice a week 31

v. Figure 4. Airway resistance 32

vi. Figure 5. FEV1/FVC percent predicted ratio 33

vii. Figure 6. Maximum FEV1/FVC ratio 34

viii. Figure 7. Hospitalization in the last year 35



About this Master's Thesis

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