Cleveland Clinic, 9500 Euclid Ave/A90, Cleveland, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
ScientificWorldJournal. 2021 Sep 15;2021:8881390. doi: 10.1155/2021/8881390. eCollection 2021.
Air pollution has been associated with poor health outcomes and continues to be a risk factor for respiratory health in children. While higher particulate matter (PM) levels are associated with increased frequency of symptoms, lower lung function, and increase airway inflammation from asthma, the precise composition of the particles that are more highly associated with poor health outcomes or healthcare utilization are not fully elucidated. PM is measured quantifiably by current air pollution monitoring systems. To better determine sources of PM and speciation of such sources, a particulate matter (PM) source apportionment study, the Cleveland Multiple Air Pollutant Study (CMAPS), was conducted in Cleveland, Ohio, in 2009-2010, which allowed more refined assessment of associations with health outcomes. This article presents an evaluation of short-term (daily) and long-term associations between motor vehicle and industrial air pollution components and pediatric asthma emergency department (ED) visits by evaluating two sets of air quality data with healthcare utilization for pediatric asthma. Exposure estimates were developed using land use regression models for long-term exposures for nitrogen dioxide (NO) and coarse (i.e., with aerodynamic diameters between 2.5 and 10 m) particulate matter (PM) and the US EPA Positive Matrix Factorization receptor model for short-term exposures to fine (<2.5 m) and coarse PM components. Exposure metrics from these two approaches were used in asthma ED visit prevalence and time series analyses to investigate seasonal-averaged short- and long-term impacts of both motor vehicles and industry emissions. Increased pediatric asthma ED visits were found for LUR coarse PM and NO estimates, which were primarily contributed by motor vehicles. Consistent, statistically significant associations with pediatric asthma visits were observed, with short-term exposures to components of fine and coarse iron PM associated with steel production. Our study is the first to combine spatial and time series analysis of ED visits for asthma using the same periods and shows that PM related to motor vehicle emissions and iron/steel production are associated with increased pediatric asthma visits.
空气污染与不良健康结果有关，并且仍然是儿童呼吸道健康的危险因素。虽然较高的颗粒物 (PM) 水平与症状发生频率增加、肺功能降低以及哮喘导致的气道炎症增加有关，但与不良健康结果或医疗保健利用相关的颗粒的精确组成尚未完全阐明。PM 可通过当前的空气污染监测系统进行定量测量。为了更好地确定 PM 的来源和此类来源的特征，在俄亥俄州克利夫兰市进行了一项颗粒物 (PM) 源分配研究，即克利夫兰多污染物研究 (CMAPS)，该研究更精细地评估了与健康结果的关联。本文通过评估两组空气质量数据与儿科哮喘急诊就诊的医疗保健利用情况，评估了机动车和工业空气污染成分与儿科哮喘急诊就诊之间的短期（每日）和长期关联。使用土地利用回归模型为长期暴露评估氮氧化物 (NO) 和粗颗粒物 (PM)（空气动力学直径在 2.5 和 10 μm 之间），以及美国环保署正向矩阵因子受体模型为短期暴露评估细颗粒物 (<2.5 μm) 和粗颗粒物成分。这两种方法的暴露指标用于哮喘急诊就诊的患病率和时间序列分析，以研究短期和长期机动车和工业排放对季节性平均的影响。发现 LUR 粗颗粒物和 NO 估算值与儿科哮喘急诊就诊增加有关，这主要是由机动车造成的。与儿科哮喘就诊相关的短期暴露于细颗粒物和粗颗粒物中的铁成分与钢铁生产有关，观察到一致的、具有统计学意义的关联。我们的研究首次使用相同的时间段对哮喘急诊就诊进行空间和时间序列分析，并表明与机动车排放和钢铁生产相关的 PM 与儿科哮喘就诊增加有关。
