title: Pediatric Emergency Visits and Short-Term Changes in PM2.5 Concentrations in the U.S. State of Georgia.
abstract: Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) have been reported in previous studies, although few were performed in nonmetropolitan areas.
  
  
  
  We estimated associations between daily PM2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state of Georgia by urbanicity classification.
  
  
  
  We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM2.5 estimates and admission dates during 1 January 2002-30 June 2010 for 2- to 18-year-olds for asthma or wheeze (n = 189,816), and for 0- to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code-level estimates of 24-hr average PM2.5 were calculated by averaging concentrations within ZIP code boundaries. We used time-stratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity.
  
  
  
  A 10-μg/m3 increase in same-day PM2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant.
  
  
  
  Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM2.5 concentrations in Georgia.
  
  
  
  Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric emergency visits and short-term changes in PM2.5 concentrations in the U.S. state of Georgia. Environ Health Perspect 124:690-696; http://dx.doi.org/10.1289/ehp.1509856.
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Strickland
authors.forename: Hua
authors.initials: H
authors.lastname: Hao
authors.forename: Xuefei
authors.initials: X
authors.lastname: Hu
authors.forename: Howard H
authors.initials: HH
authors.lastname: Chang
authors.forename: Lyndsey A
authors.initials: LA
authors.lastname: Darrow
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000706:statistics & numerical data*; D001249:Asthma / Q000453:epidemiology; D004636:Emergency Service, Hospital; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005845:Georgia / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D052638:Particulate Matter / Q000032:analysis*; D011014:Pneumonia / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter