Air pollution, urgent asthma medical visits and the modifying effect of neighborhood asthma prevalence

Stephanie Lovinsky-Desir, Luis M. Acosta, Andrew G. Rundle, Rachel L. Miller, Inge F. Goldstein, Judith S. Jacobson, Steven N. Chillrud, Matthew S. Perzanowski

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Social and environmental stressors may modify associations between environmental pollutants and asthma symptoms. We examined if neighborhood asthma prevalence (higher: HAPN vs. lower: LAPN), a surrogate for underlying risk factors for asthma, modified the relationship between pollutants and urgent asthma visits. Methods: Through zip code, home addresses were linked to New York City Community Air Survey’s land use regression model for street-level, annual average nitrogen dioxide (NO 2 ), particulate matter (PM 2.5 ), elemental carbon (EC), summer average ozone (O 3 ), winter average sulfur dioxide (SO 2 ) concentrations. Poisson regression models were fit to estimate the association (prevalence ratio, PR) between pollutant exposures and seeking urgent asthma care. Results: All pollutants, except O 3 were higher in HAPN than LAPN (P < 0.01). Neighborhood asthma prevalence modified the relationship between pollutants and urgent asthma (P-interaction < 0.01, for NO 2 and SO 3 ). Associations between pollutants and urgent asthma were observed only in LAPN (NO 2 : PR = 1.38, P = 0.01; SO 3 : PR = 1.85, P = 0.04). No association was observed between pollutants and urgent asthma among children in HAPN (P > 0.05). Conclusions: Relationships between modeled street-level pollutants and urgent asthma were stronger in LAPN compared to HAPN. Social stressors that may be more prevalent in HAPN than LAPN, could play a greater role in asthma exacerbations in HAPN vs. pollutant exposure alone.

Original languageEnglish
Pages (from-to)36-42
Number of pages7
JournalPediatric Research
Volume85
Issue number1
DOIs
StatePublished - 1 Jan 2019
Externally publishedYes

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