title: Air pollution and emergency department visits for asthma among Ohio Medicaid recipients, 1991-1996.
abstract: We examined the effects of nitrogen dioxide (NO(2)), ozone (O(3)), particulate matter of <10 microm aerodynamic diameter (PM(10)), and sulfur dioxide (SO(2)) on asthmatics ages 5-34 years enrolled in Medicaid in Cincinnati, Cleveland, and Columbus, OH (N=5416). Our study period was for the summer months, June-August, from July 1, 1991 to June 30, 1996. We preformed Poisson regression analyses for the number of daily emergency department (ED) visits for asthma in each city and on the aggregate data controlling for time trends and minimum temperature. We found a 12% increased likelihood of an asthma ED visit per 50 microg/m(3) increase in PM(10) in Cleveland [95% confidence interval (CI)=0-27%] and a 35% increase per 50 microg/m(3) increase in SO(2) in Cincinnati (95% CI=9-21%). When data were analyzed for all three cities combined, the risk of an ED visit increased for all pollutant increases and specifically by 12% (95% CI=1-23%) per 50 microg/m(3) increase in SO(2). Attributable risk estimates show a five times greater impact on Cleveland over Cincinnati or Columbus. Between 1991 and 1996, air pollutants in Cincinnati, Cleveland, and Columbus increased ED visits for asthmatics enrolled in Medicaid.
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA. dhj3@hotmail.com
authors.forename: Dena H
authors.initials: DH
authors.lastname: Jaffe
authors.forename: Mendel E
authors.initials: ME
authors.lastname: Singer
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Rimm
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D001249:Asthma / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D009585:Nitrogen Dioxide / Q000009:adverse effects*; D009820:Ohio / Q000453:epidemiology; D010083:Oxidants, Photochemical / Q000009:adverse effects*; D010126:Ozone / Q000009:adverse effects*; D010316:Particle Size; D018570:Risk Assessment; D012621:Seasons; D014505:Urban Population
chemical_list: D000393:Air Pollutants; D010083:Oxidants, Photochemical; D010126:Ozone; D009585:Nitrogen Dioxide