title: Airborne particulate matter from primarily geologic, non-industrial sources at levels below National Ambient Air Quality Standards is associated with outpatient visits for asthma and quick-relief medication prescriptions among children less than 20 years old enrolled in Medicaid in Anchorage, Alaska.
abstract: In Anchorage, Alaska, particulates with aerodynamic diameter < or = 10 micro m (PM(10)) arise primarily from natural, geologic sources, and particulates with aerodynamic diameter < or = 2.5 micro m (PM(2.5)) arise primarily from automobile emissions. The current study used a population-based time-series analysis design to evaluate the effects of daily and weekly PM(10) and PM(2.5) on respiratory health outcomes among children <20 years of age residing in Anchorage enrolled in Medicaid. All generated estimating equations models were adjusted for season, year, weekends, temperature, wind speed, and precipitation. Relative to the days with PM(10) mass concentration < or = 13 micro g/m(3), a significant 9.3% increase (RR: 1.093, 95% CI: 1.004-1.191) in the rate of outpatient visits for asthma occurred during days with PM(10) of 20-33 micro g/m(3). No further dose-response occurred for days with PM(10) > or = 34 micro g/m(3). A significant 18.1% increase (RR: 1.181, 95% CI: 1.010-1.381) in the rate of quick-relief medication prescriptions occurred during days with PM(10) of 34-60 micro g/m(3), and a 28.8% increase (RR: 1.288, 95% CI: 1.026-1.619) occurred during days with PM(10) > or = 61 micro g/m(3). Similar results for outpatient asthma visits and quick-relief medication occurred in weekly models. There were no significant associations with PM(2.5) in either daily or weekly models. These subtle but statistically significant associations suggest that non-industrial, geologic sources of PM(10) may have measurable health effects at levels below current national standards.
authors.affiliation: Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA. mchimonas@msn.com
authors.forename: Marc-Andre R
authors.initials: MA
authors.lastname: Chimonas
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
mesh_terms: D000293:Adolescent; D000413:Alaska / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D015233:Models, Statistical; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis* / Q000592:standards
chemical_list: D018927:Anti-Asthmatic Agents; D052638:Particulate Matter