title: Environmental public health tracking of childhood asthma using California health interview survey, traffic, and outdoor air pollution data.
abstract: BACKGROUND
  Despite extensive evidence that air pollution affects childhood asthma, state-level and national-level tracking of asthma outcomes in relation to air pollution is limited.
  
  
  OBJECTIVE
  Our goals were to evaluate the feasibility of linking the 2001 California Health Interview Survey (CHIS), air monitoring, and traffic data; estimate associations between traffic density (TD) or outdoor air pollutant concentrations and childhood asthma morbidity; and evaluate the usefulness of such databases, linkages, and analyses to Environmental Public Health Tracking (EPHT).
  
  
  METHODS
  We estimated TD within 500 feet of residential cross-streets of respondents and annual average pollutant concentrations based on monitoring station measurements. We used logistic regression to examine associations with reported asthma symptoms and emergency department (ED) visits/hospitalizations.
  
  
  RESULTS
  Assignment of TD and air pollution exposures for cross-streets was successful for 82% of children with asthma in Los Angeles and San Diego, California, Counties. Children with asthma living in high ozone areas and areas with high concentrations of particulate matter < 10 microm in aerodynamic diameter experienced symptoms more frequently, and those living close to heavy traffic reported more ED visits/hospitalizations. The advantages of the CHIS for asthma EPHT include a large and representative sample, biennial data collection, and ascertainment of important socio-demographic and residential address information. Disadvantages are its cross-sectional design, reliance on parental reports of diagnoses and symptoms, and lack of information on some potential confounders.
  
  
  CONCLUSIONS
  Despite limitations, the CHIS provides a useful framework for examining air pollution and childhood asthma morbidity in support of EPHT, especially because later surveys address some noted gaps. We plan to employ CHIS 2003 and 2005 data and novel exposure assessment methods to re-examine the questions raised here.
authors.affiliation: Department of Epidemiology and Center for Occupational and Environmental Health, School of Public Health, University of California, Los Angeles, California, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Wilhelm
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Meng
authors.forename: Rudolph P
authors.initials: RP
authors.lastname: Rull
authors.forename: Paul
authors.initials: P
authors.lastname: English
authors.forename: John
authors.initials: J
authors.lastname: Balmes
authors.forename: Beate
authors.initials: B
authors.lastname: Ritz
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000633:toxicity*; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D011634:Public Health
chemical_list: D000393:Air Pollutants
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