An investigation of the environmental determinants of asthma hospitalizations: An applied spatial approach

Several previous studies have connected asthma exacerbations with environmental factors such as pollutants. However, the majority do not analyze the information spatially. The objective of this study was to evaluate the relationship between asthma hospital admissions and several environmental variables in mainland Portugal using spatial data from remote sensing and spatial modeling. A set of five environmental variables were considered: near-surface air temperature (Ta) from the temperature profile of the Moderate Resolution Imaging Spectroradiometer (MODIS); relative humidity (RH) from meteorological station data interpolated by kriging; vegetation density from MODIS Normalized Difference Vegetation Index (NDVI); and space-time estimates of nitrogen dioxide (NO2) and particulate matter less than 10 m m( PM10), both from Land-Use Regression (LUR) models based on data from air quality stations. Districts were aggregated into three groups based on their percent urban cover, and the municipality was chosen as the sampling unit to assess the relationship between asthma hospital admission rates and environmental variables by season for the years 2003e2008. In the most urban group, Ta, NDVI, and NO2 had consistent relationships with asthma in all seasons (Pearson correlation coefficients ranging from 0.351 to 0.600, � 0.376 to � 0.498, and 0.405 to 0.513, respectively). The associations in the other groups were very weak or non-existent. The percentage of urban cover influences the relationship between the environment and asthma. The results suggest that asthmatic people living in highly urbanized and sparsely vegetated areas are at a greater risk of suffering severe asthma attacks that lead to hospital admissions.

[1]  B. Reiser,et al.  High prevalence of childhood asthma in Northern Israel is linked to air pollution by particulate matter: evidence from GIS analysis and Bayesian Model Averaging , 2012, International Journal of Environmental Health Research.

[2]  S. Johnston,et al.  Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children , 2003, The Lancet.

[3]  K. Berhane,et al.  Prospective study of air pollution and bronchitic symptoms in children with asthma. , 2003, American journal of respiratory and critical care medicine.

[4]  S. Johnston,et al.  Air pollution and infection in respiratory illness. , 2003, British medical bulletin.

[5]  Ferhat Karaca,et al.  Particulate Matter (PM2.5, PM10-2.5, and PM10) and Children's Hospital Admissions for Asthma and Respiratory Diseases: A Bidirectional Case-Crossover Study , 2008, Journal of toxicology and environmental health. Part A.

[6]  M. Krishna Reddy.  Geostatistics with Applications in Earth Sciences (2nd Edition). , 2010 .

[7]  Pierre Goovaerts,et al.  Use of land surface remotely sensed satellite and airborne data for environmental exposure assessment in cancer research , 2010, Journal of Exposure Science and Environmental Epidemiology.

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

[9]  É. Lavigne,et al.  Air pollution and emergency department visits for asthma in Windsor, Canada. , 2012, Canadian journal of public health = Revue canadienne de sante publique.

[10]  J. Zimmerman,et al.  Respiratory tract viral infections in inner-city asthmatic adults. , 1998, Archives of internal medicine.

[11]  Weichun Ma,et al.  Analysis of land use/land cover change, population shift, and their effects on spatiotemporal patterns of urban heat islands in metropolitan Shanghai, China , 2013 .

[12]  R. Pauwels,et al.  GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION , 1996 .

[13]  T. Collins,et al.  Climate change and environmental injustice in a bi-national context , 2012 .

[14]  Sudipto Banerjee,et al.  An analysis of asthma hospitalizations, air pollution, and weather conditions in Los Angeles County, California. , 2012, The Science of the total environment.

[15]  David A. Seal,et al.  The Shuttle Radar Topography Mission , 2007 .

[16]  A J Graham,et al.  Spatial analysis for epidemiology. , 2004, Acta tropica.

[17]  W. Pierson,et al.  Particulate air pollution and hospital emergency room visits for asthma in Seattle. , 1993, The American review of respiratory disease.

[18]  Lester L. Yuan,et al.  Comparison of spatial interpolation methods for the estimation of air quality data , 2004, Journal of Exposure Analysis and Environmental Epidemiology.

[19]  Morton Lippmann,et al.  Acute respiratory health effects of air pollution on children with asthma in US inner cities. , 2008, The Journal of allergy and clinical immunology.

[20]  J. Landry,et al.  La problématique de l'ozone , 1991 .

[21]  G. Lemasters,et al.  A Review of Land-use Regression Models for Characterizing Intraurban Air Pollution Exposure , 2007, Inhalation toxicology.

[22]  Nuno Carvalhais,et al.  Estimating air surface temperature in Portugal using MODIS LST data , 2012 .

[23]  A. Kelly,et al.  Air pollution and childhood asthma emergency hospital admissions: Estimating intra-city regional variations , 2005, International journal of environmental health research.

[24]  Michael S. Davis,et al.  Cold weather exercise and airway cytokine expression. , 2005, Journal of applied physiology.

[25]  Tiago Jacinto,et al.  Prevalence of asthma in Portugal - The Portuguese National Asthma Survey , 2012, Clinical and Translational Allergy.

[26]  D. D. Sarma.  Geostatistics with applications in earth sciences , 2002 .

[27]  Kerrie Mengersen,et al.  Spatiotemporal relationship between particle air pollution and respiratory emergency hospital admissions in Brisbane, Australia. , 2007, The Science of the total environment.

[28]  T. Wong,et al.  Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong , 2007, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[29]  T. Haahtela,et al.  Disconnection of man and the soil: reason for the asthma and atopy epidemic? , 2006, The Journal of allergy and clinical immunology.

[30]  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.

[31]  P. Saldiva,et al.  Urban air pollution: a representative survey of PM2.5 mass concentrations in six Brazilian cities , 2011, Air Quality, Atmosphere & Health.

[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]  P. Ceccato,et al.  Evaluation of MODIS land surface temperature data to estimate air temperature in different ecosystems over Africa , 2010 .

[34]  Xiaohui Xu,et al.  Predicting regional space–time variation of PM2.5 with land-use regression model and MODIS data , 2011, Environmental Science and Pollution Research.

[35]  Rudolph P. Rull,et al.  Environmental Public Health Tracking of Childhood Asthma Using California Health Interview Survey, Traffic, and Outdoor Air Pollution Data , 2008, Environmental health perspectives.

[36]  Y. Matsuoka,et al.  Analysis of indoor PM2.5 exposure in Asian countries using time use survey. , 2011, The Science of the total environment.