The association between childhood asthma prevalence and monitored air pollutants in metropolitan areas, United States, 2001-2004.
BACKGROUND
Air pollution exposure has been linked to adverse respiratory health outcomes among children, primarily in studies of acute exposures that are often in limited geographic areas. We sought to assess the association between chronic outdoor air pollution exposure, as measured by 12-month averages by county, and asthma among children in metropolitan areas across the nation.


METHODS
Eligible children included those aged 3-17 years residing in US metropolitan areas who were sampled in the 2001-2004 National Health Interview Survey (N=34,073). 12-month average air pollutant levels for sulfur dioxide, nitrogen dioxide, ozone and particulate matter were compiled by county for 2000-2004. Eligible children were linked to pollutant levels for the previous 12 months for their county of residence. Adjusted odds ratios of having current asthma or an asthma attack in the past 12 months were estimated in single pollutant logistic regression models.


RESULTS
Children in counties with ozone and, to a less consistent degree, particulate matter levels in the highest quartile were more likely to have current asthma and/or a recent asthma attack than children residing in counties with the lowest pollution levels; the adjusted odds for current asthma for the highest quartile of estimated ozone exposure was 1.56 (95% confidence interval [CI]: 1.15, 2.10) and for recent asthma attack 1.38 (95% CI: 0.99, 1.91). No associations were found with sulfur dioxide or nitrogen dioxide levels.


CONCLUSIONS
Although the current US standard for ozone is based on short-term exposure, this cross-sectional study suggests that chronic (12-month) exposure to ozone and particles is related to asthma outcomes among children in metropolitan areas throughout the US.
Akinbami
Lara J
LJ
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. lea8@cdc.gov
Lynch
Courtney D
CD
Parker
Jennifer D
JD
Woodruff
Tracey J
TJ
D000293:Adolescent; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000706:statistics & numerical data; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002947:Cities / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008297:Male; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D013458:Sulfur Dioxide / Q000032:analysis; D014481:United States / Q000453:epidemiology
D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone; D009585:Nitrogen Dioxide