Ambient ozone exposure and children’s acute asthma in New York City: a case-crossover analysis

BackgroundChildhood asthma morbidity has been associated with ambient ozone in case-crossover studies. Varying effects of ozone by child age and sex, however, have been less explored.MethodsThis study evaluates associations between ozone exposure and asthma emergency department visits and hospitalizations among boys and girls aged 5-17 years in New York City for the 2005-2011 warm season period. Time-stratified case-crossover analysis was conducted and, for comparison, time-series analysis controlling for season, day-of-week, same-day and delayed effects of temperature and relative humidity were also performed.ResultsWe found associations between ambient ozone levels and childhood asthma emergency department visits and hospitalizations in New York City, although the relationships varied among boys and girls and by age group. For an increase of interquartile range (0.013 ppm) in ozone, there was a 2.9-8.4% increased risk for boys and 5.4-6.5% for girls in asthma emergency department visits; and 8.2% increased risk for girls in hospitalizations. Among girls, we observed stronger associations among older children (10-13 and 14-17 year age groups). We did not observe significant modification by age for boys. Boys exhibited a more prompt response (lag day 1) to ozone than did girls (lag day 3), but significant associations for girls were retained longer, through lag day 6.ConclusionsOur study indicates significant variance in associations between short-term ozone concentrations and asthma events by child sex and age. Differences in ozone response for boys and girls, before and after puberty, may point towards both social (gendered) and biological (sex-linked) sources of effect modification.

[1]  Kazuhiko Ito,et al.  Age-related association of fine particles and ozone with severe acute asthma in New York City. , 2010, The Journal of allergy and clinical immunology.

[2]  L. Sheppard,et al.  An association between fine particles and asthma emergency department visits for children in Seattle. , 1999, Environmental health perspectives.

[3]  H. Frumkin,et al.  Ambient Air Pollution and Respiratory Emergency Department Visits , 2005, Epidemiology.

[4]  P. Potter.  Current guidelines for the management of asthma in young children , 2009, Allergy, asthma & immunology research.

[5]  J. Niemi,et al.  Ozone and cause-specific cardiorespiratory morbidity and mortality , 2009, Journal of Epidemiology & Community Health.

[6]  R. Burnett,et al.  Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. , 1999, Archives of environmental health.

[7]  T. Bateson,et al.  Control for seasonal variation and time trend in case-crossover studies of acute effects of environmental exposures. , 1999, Epidemiology.

[8]  E. Ganor,et al.  Effects of Atmospheric Pollutants on Children Asthma Outbreaks , 2009 .

[9]  J. R. Scotti,et al.  Available From , 1973 .

[10]  A. Gow,et al.  Prolonged injury and altered lung function after ozone inhalation in mice with chronic lung inflammation. , 2012, American journal of respiratory cell and molecular biology.

[11]  Russell S. Vose,et al.  Maximum and minimum temperature trends for the globe: An update through 2004 , 2005 .

[12]  T. Bateson,et al.  Selection Bias and Confounding in Case-Crossover Analyses of Environmental Time-Series Data , 2001, Epidemiology.

[13]  M. Schatz,et al.  Sex differences among children 2–13 years of age presenting at the emergency department with acute asthma , 2004, Pediatric pulmonology.

[14]  Gregory Taylor,et al.  Hospital readmissions for asthma in children and young adults in Canada , 2003, Pediatric pulmonology.

[15]  Jong-Tae Lee,et al.  Relationship between ambient ozone concentrations and daily hospital admissions for childhood asthma/atopic dermatitis in two cities of Korea during 2004–2005 , 2010, International journal of environmental health research.

[16]  J. Clougherty,et al.  A Growing Role for Gender Analysis in Air Pollution Epidemiology , 2009, Environmental health perspectives.

[17]  E. Samoli,et al.  Acute effects of air pollution on pediatric asthma exacerbation: evidence of association and effect modification. , 2011, Environmental research.

[18]  A. Tobías,et al.  Case-Crossover Analysis of Air Pollution Health Effects: A Systematic Review of Methodology and Application , 2010, Environmental health perspectives.

[19]  Daniel Krewski,et al.  The influence of ambient coarse particulate matter on asthma hospitalization in children: case-crossover and time-series analyses. , 2002, Environmental health perspectives.

[20]  R. Burnett,et al.  Effect of short-term exposure to gaseous pollution on asthma hospitalisation in children: a bi-directional case-crossover analysis , 2003, Journal of epidemiology and community health.

[21]  P. Villeneuve,et al.  Outdoor air pollution and emergency department visits for asthma among children and adults: A case-crossover study in northern Alberta, Canada , 2007, Environmental health : a global access science source.

[22]  F. Gilliland.  Outdoor Air Pollution, Genetic Susceptibility, and Asthma Management: Opportunities for Intervention to Reduce the Burden of Asthma , 2009, Pediatrics.

[23]  James A Mulholland,et al.  Short-Term Associations Between Ambient Air Pollutants and Pediatric Asthma Emergency Department Visits , 2010, American journal of respiratory and critical care medicine.

[24]  Y. Lee,et al.  Gender Differences and Effect of Air Pollution on Asthma in Children with and without Allergic Predisposition: Northeast Chinese Children Health Study , 2011, PloS one.

[25]  F. Dominici,et al.  Ozone and short-term mortality in 95 US urban communities, 1987-2000. , 2004, JAMA.

[26]  D. Schwartz,et al.  Ambient ozone primes pulmonary innate immunity in mice. , 2007, Journal of immunology.

[27]  Brian H Rowe,et al.  Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis , 2009, Environmental health : a global access science source.

[28]  C. Bjornson,et al.  Gender differences in asthma in childhood and adolescence. , 2000, The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia.

[29]  M Lippmann,et al.  Respiratory hospital admissions and summertime haze air pollution in Toronto, Ontario: consideration of the role of acid aerosols. , 1994, Environmental research.

[30]  A. Rimm,et al.  Air pollution and emergency department visits for asthma among Ohio Medicaid recipients, 1991-1996. , 2003, Environmental research.

[31]  J. Castro‐Rodriguez,et al.  Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. , 2001, American journal of respiratory and critical care medicine.

[32]  H. Burkom,et al.  Pediatric patient asthma-related emergency department visits and admissions in Washington, DC, from 2001–2004, and associations with air quality, socio-economic status and age group , 2007, Environmental health : a global access science source.

[33]  J. Garnier,et al.  Visits to the Emergency Room for Asthma Attacks and Short-Term Variations in Air Pollution , 2004, Respiration.

[34]  R. Conolly,et al.  Assessing The Health Effects and Risks Associated with Children's Inhalation Exposures—Asthma and Allergy , 2007, Journal of toxicology and environmental health. Part A.

[35]  Thomas Lumley,et al.  Case–Crossover Analyses of Air Pollution Exposure Data: Referent Selection Strategies and Their Implications for Bias , 2005, Epidemiology.

[36]  L. Akinbami,et al.  National surveillance for asthma--United States, 1980-2004. , 2007, Morbidity and mortality weekly report. Surveillance summaries.

[37]  J. Díaz,et al.  Role of Saharan dust in the relationship between particulate matter and short-term daily mortality among the elderly in Madrid (Spain). , 2010, The Science of the total environment.

[38]  S. Redline,et al.  Challenges in interpreting gender differences in asthma. , 1994, American journal of respiratory and critical care medicine.

[39]  Carlos A Camargo,et al.  Sex differences in the presentation and course of asthma hospitalizations. , 2006, Chest.

[40]  George D Thurston,et al.  The role of air pollution in asthma and other pediatric morbidities. , 2005, The Journal of allergy and clinical immunology.

[41]  W. Navidi,et al.  Bidirectional case-crossover designs for exposures with time trends. , 1998, Biometrics.

[42]  K. Beswick,et al.  CHILDHOOD ASTHMA , 1983, The Lancet.

[43]  I. Adcock,et al.  A comprehensive analysis of oxidative stress in the ozone-induced lung inflammation mouse model. , 2014, Clinical science.

[44]  M. Worm,et al.  Impact of gender on asthma in childhood and adolescence: a GA2LEN review , 2007, Allergy.

[45]  Christian Monn,et al.  Exposure assessment of air pollutants: a review on spatial heterogeneity and indoor/outdoor/personal exposure to suspended particulate matter, nitrogen dioxide and ozone , 2001 .

[46]  M. Klein,et al.  Comparison of emergency department and hospital admissions data for air pollution time-series studies , 2012, Environmental Health.

[47]  A. Peters,et al.  Comparison of different methods in analyzing short-term air pollution effects in a cohort study of susceptible individuals , 2006, Epidemiologic perspectives & innovations : EP+I.

[48]  D. Dockery,et al.  Particulate and ozone pollutant effects on the respiratory function of children in southwest Mexico City. , 1999, Epidemiology.

[49]  P. Ribera,et al.  Modeling of air pollution and its relationship with mortality and morbidity in Madrid, Spain , 1999, International archives of occupational and environmental health.

[50]  B. Jalaludin,et al.  Air pollution and ED visits for asthma in Australian children: a case-crossover analysis , 2008, International archives of occupational and environmental health.

[51]  L. Akinbami,et al.  The association between childhood asthma prevalence and monitored air pollutants in metropolitan areas, United States, 2001-2004. , 2010, Environmental research.

[52]  Kazuhiko Ito,et al.  Characterization of PM2.5, gaseous pollutants, and meteorological interactions in the context of time-series health effects models , 2007, Journal of Exposure Science and Environmental Epidemiology.

[53]  F. Lipfert.  A critical review of studies of the association between demands for hospital services and air pollution. , 1993, Environmental health perspectives.

[54]  R. Buchdahl,et al.  Association between air pollution and acute childhood wheezy episodes: prospective observational study , 1996, BMJ.

[55]  A Seaton,et al.  Asthma admissions and thunderstorms: a study of pollen, fungal spores, rainfall, and ozone. , 2001, QJM : monthly journal of the Association of Physicians.

[56]  Oar,et al.  Excessive Heat Events Guidebook , 2014 .

[57]  K. Berhane,et al.  Asthma in exercising children exposed to ozone: a cohort study , 2002, The Lancet.

[58]  M. Osman.  Therapeutic implications of sex differences in asthma and atopy , 2003, Archives of disease in childhood.

[59]  A. Wilson,et al.  Air pollution, weather, and respiratory emergency room visits in two northern New England cities: an ecological time-series study. , 2005, Environmental research.

[60]  I. Choi.  Gender-Specific Asthma Treatment , 2010, Allergy, asthma & immunology research.

[61]  Sarah Johnson,et al.  Intra-urban spatial variability in wintertime street-level concentrations of multiple combustion-related air pollutants: The New York City Community Air Survey (NYCCAS) , 2013, Journal of Exposure Science and Environmental Epidemiology.

[62]  J Schwartz,et al.  The distributed lag between air pollution and daily deaths. , 2000, Epidemiology.

[63]  E. Mutius.  Progression of allergy and asthma through childhood to adolescence. , 1996 .

[64]  Thomas Lumley,et al.  Bias in the case – crossover design: implications for studies of air pollution , 2000 .

[65]  F. Biro,et al.  Puberty in girls of the 21st century. , 2012, Journal of pediatric and adolescent gynecology.

[66]  Christophe Declercq,et al.  The Relation Between Temperature, Ozone, and Mortality in Nine French Cities During the Heat Wave of 2003 , 2006, Environmental health perspectives.

[67]  K. Ito,et al.  Cigarette smoking and ozone-associated emergency department use for asthma by adults in New York City. , 1999, American journal of respiratory and critical care medicine.

[68]  Thomas F Bateson,et al.  Children's Response to Air Pollutants , 2007, Journal of toxicology and environmental health. Part A.

[69]  Min Zhang,et al.  A model of chronic inflammation and pulmonary emphysema after multiple ozone exposures in mice. , 2011, American journal of physiology. Lung cellular and molecular physiology.

[70]  D. Postma,et al.  Gender differences in asthma development and remission during transition through puberty: the TRacking Adolescents' Individual Lives Survey (TRAILS) study. , 2010, The Journal of allergy and clinical immunology.

[71]  H. Brumberg,et al.  Ambient Air Pollution: Health Hazards to Children , 2013, Pediatrics.

[72]  Bohn Stafleu van Loghum,et al.  Online … , 2002, LOG IN.

[73]  R. Silverman,et al.  Association of ambient fine particles with out-of-hospital cardiac arrests in New York City. , 2010, American journal of epidemiology.

[74]  J. Serwint,et al.  Secondary Sexual Characteristics in Boys: Data From the Pediatric Research in Office Settings Network , 2012, Pediatrics.

[75]  M. Mills,et al.  Association between ozone and emergency department visits: an ecological study , 2011, International journal of environmental health research.