Abstract
People with asthma who live near or downwind from a source of toxic emissions commonly express concerns about the possible impact of hazardous air pollution on their health, especially when these emissions are visible or odorous. Citizens frequently turn to their local and state health departments for answers, but health departments face many challenges in addressing these concerns. These challenges include a lack of asthma statistics at the local level, limited exposure information, and a paucity of scientific knowledge about the contributions of hazardous air pollutants to asthma induction or exacerbation. Health agencies are creatively developing methods to address these challenges while working toward improving asthma surveillance data at the state and local levels. Recent community health investigations suggest that hazardous air pollutants that are occupational asthmagens or associated with odors may deserve more attention. In seeking to address community concerns about hazardous air pollution and asthma, community health investigations may also help to fill gaps in our scientific knowledge and identify areas for further research or environmental intervention. The solutions to community problems associated with environmental contamination and asthma, however, require sustained, coordinated efforts by public and private groups and citizens. Public health agencies can make a unique contribution to this effort, but additional resources and support will be required to develop information systems and epidemiologic capacity at the state and local levels.
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Selected References
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- Antó J. M., Sunyer J., Rodriguez-Roisin R., Suarez-Cervera M., Vazquez L. Community outbreaks of asthma associated with inhalation of soybean dust. Toxicoepidemiological Committee. N Engl J Med. 1989 Apr 27;320(17):1097–1102. doi: 10.1056/NEJM198904273201701. [DOI] [PubMed] [Google Scholar]
- Banks D. E., Rando R. J., Barkman H. W., Jr Persistence of toluene diisocyanate-induced asthma despite negligible workplace exposures. Chest. 1990 Jan;97(1):121–125. doi: 10.1378/chest.97.1.121. [DOI] [PubMed] [Google Scholar]
- Bates D. V. Observations on asthma. Environ Health Perspect. 1995 Sep;103 (Suppl 6):243–247. doi: 10.1289/ehp.95103s6243. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beggs P. J., Curson P. H. An integrated environmental asthma model. Arch Environ Health. 1995 Mar-Apr;50(2):87–94. doi: 10.1080/00039896.1995.9940884. [DOI] [PubMed] [Google Scholar]
- Boss L. P., Kreutzer R. A., Luttinger D., Leighton J., Wilcox K., Redd S. C. The public health surveillance of asthma. J Asthma. 2001 Feb;38(1):83–89. doi: 10.1081/jas-100000025. [DOI] [PubMed] [Google Scholar]
- Claudio L., Torres T., Sanjurjo E., Sherman L. R., Landrigan P. J. Environmental health sciences education--a tool for achieving environmental equity and protecting children. Environ Health Perspect. 1998 Jun;106 (Suppl 3):849–855. doi: 10.1289/ehp.98106849. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dearry A. D., Collman G. W., Saint C., Fields N., Redd S. Building a network of research in children's environmental health. Environ Health Perspect. 1999 Jun;107 (Suppl 3):391–392. doi: 10.1289/ehp.99107s3391. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Friedman M. S., Powell K. E., Hutwagner L., Graham L. M., Teague W. G. Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA. 2001 Feb 21;285(7):897–905. doi: 10.1001/jama.285.7.897. [DOI] [PubMed] [Google Scholar]
- Gilliland F. D., McConnell R., Peters J., Gong H., Jr A theoretical basis for investigating ambient air pollution and children's respiratory health. Environ Health Perspect. 1999 Jun;107 (Suppl 3):403–407. doi: 10.1289/ehp.99107s3403. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Health effects of outdoor air pollution. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Am J Respir Crit Care Med. 1996 Jan;153(1):3–50. doi: 10.1164/ajrccm.153.1.8542133. [DOI] [PubMed] [Google Scholar]
- Koenig J. Q. Air pollution and asthma. J Allergy Clin Immunol. 1999 Oct;104(4 Pt 1):717–722. doi: 10.1016/s0091-6749(99)70280-0. [DOI] [PubMed] [Google Scholar]
- Krämer U., Koch T., Ranft U., Ring J., Behrendt H. Traffic-related air pollution is associated with atopy in children living in urban areas. Epidemiology. 2000 Jan;11(1):64–70. doi: 10.1097/00001648-200001000-00014. [DOI] [PubMed] [Google Scholar]
- Kyle A. D., Wright C. C., Caldwell J. C., Buffler P. A., Woodruff T. J. Evaluating the health significance of hazardous air pollutants using monitoring data. Public Health Rep. 2001 Jan-Feb;116(1):32–44. doi: 10.1016/S0033-3549(04)50020-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leikauf G. D., Kline S., Albert R. E., Baxter C. S., Bernstein D. I., Bernstein J., Buncher C. R. Evaluation of a possible association of urban air toxics and asthma. Environ Health Perspect. 1995 Sep;103 (Suppl 6):253–271. doi: 10.1289/ehp.95103s6253. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewis C. W. Sources of air pollutants indoors: VOC and fine particulate species. J Expo Anal Environ Epidemiol. 1991 Jan;1(1):31–44. [PubMed] [Google Scholar]
- Loomis D. Sizing up air pollution research. Epidemiology. 2000 Jan;11(1):2–4. doi: 10.1097/00001648-200001000-00002. [DOI] [PubMed] [Google Scholar]
- Mannino D. M., Homa D. M., Pertowski C. A., Ashizawa A., Nixon L. L., Johnson C. A., Ball L. B., Jack E., Kang D. S. Surveillance for asthma--United States, 1960-1995. MMWR CDC Surveill Summ. 1998 Apr 24;47(1):1–27. [PubMed] [Google Scholar]
- McConnell Rob, Berhane Kiros, Gilliland Frank, London Stephanie J., Islam Talat, Gauderman W. James, Avol Edward, Margolis Helene G., Peters John M. Asthma in exercising children exposed to ozone: a cohort study. Lancet. 2002 Feb 2;359(9304):386–391. doi: 10.1016/S0140-6736(02)07597-9. [DOI] [PubMed] [Google Scholar]
- McDonnell W. F., Abbey D. E., Nishino N., Lebowitz M. D. Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: the AHSMOG Study. Environ Res. 1999 Feb;80(2 Pt 1):110–121. doi: 10.1006/enrs.1998.3894. [DOI] [PubMed] [Google Scholar]
- Orloff K. G., Batts-Osborne D., Kilgus T., Metcalf S., Cooper M. Antibodies to toluene diisocyanate in an environmentally exposed population. Environ Health Perspect. 1998 Oct;106(10):665–666. doi: 10.1289/ehp.98106665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Plopper C. G., Fanucchi M. V. Do urban environmental pollutants exacerbate childhood lung diseases? Environ Health Perspect. 2000 Jun;108(6):A252–A253. doi: 10.1289/ehp.108-a252. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pope C. A., 3rd Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am J Public Health. 1989 May;79(5):623–628. doi: 10.2105/ajph.79.5.623. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shim C., Williams M. H., Jr Effect of odors in asthma. Am J Med. 1986 Jan;80(1):18–22. doi: 10.1016/0002-9343(86)90043-4. [DOI] [PubMed] [Google Scholar]
- Shusterman D. Critical review: the health significance of environmental odor pollution. Arch Environ Health. 1992 Jan-Feb;47(1):76–87. doi: 10.1080/00039896.1992.9935948. [DOI] [PubMed] [Google Scholar]
- Shusterman D. Odor-associated health complaints: competing explanatory models. Chem Senses. 2001 Mar;26(3):339–343. doi: 10.1093/chemse/26.3.339. [DOI] [PubMed] [Google Scholar]
- Suh H. H., Bahadori T., Vallarino J., Spengler J. D. Criteria air pollutants and toxic air pollutants. Environ Health Perspect. 2000 Aug;108 (Suppl 4):625–633. doi: 10.1289/ehp.00108s4625. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tager I. B. Current view of epidemiologic study designs for occupational and environmental lung diseases. Environ Health Perspect. 2000 Aug;108 (Suppl 4):615–623. doi: 10.1289/ehp.00108s4615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wallace L. A., Pellizzari E. D., Hartwell T. D., Sparacino C., Whitmore R., Sheldon L., Zelon H., Perritt R. The TEAM (Total Exposure Assessment Methodology) Study: personal exposures to toxic substances in air, drinking water, and breath of 400 residents of New Jersey, North Carolina, and North Dakota. Environ Res. 1987 Aug;43(2):290–307. doi: 10.1016/s0013-9351(87)80030-0. [DOI] [PubMed] [Google Scholar]
- Ware J. H., Spengler J. D., Neas L. M., Samet J. M., Wagner G. R., Coultas D., Ozkaynak H., Schwab M. Respiratory and irritant health effects of ambient volatile organic compounds. The Kanawha County Health Study. Am J Epidemiol. 1993 Jun 15;137(12):1287–1301. doi: 10.1093/oxfordjournals.aje.a116639. [DOI] [PubMed] [Google Scholar]
- White M. C., Etzel R. A., Olson D. R., Goldstein I. F. Reexamination of epidemic asthma in New Orleans, Louisiana, in relation to the presence of soy at the harbor. Am J Epidemiol. 1997 Mar 1;145(5):432–438. doi: 10.1093/oxfordjournals.aje.a009125. [DOI] [PubMed] [Google Scholar]
- Woodruff T. J., Axelrad D. A., Caldwell J., Morello-Frosch R., Rosenbaum A. Public health implications of 1990 air toxics concentrations across the United States. Environ Health Perspect. 1998 May;106(5):245–251. doi: 10.1289/ehp.98106245. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wyler C., Braun-Fahrländer C., Künzli N., Schindler C., Ackermann-Liebrich U., Perruchoud A. P., Leuenberger P., Wüthrich B. Exposure to motor vehicle traffic and allergic sensitization. The Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) Team. Epidemiology. 2000 Jul;11(4):450–456. doi: 10.1097/00001648-200007000-00015. [DOI] [PubMed] [Google Scholar]
