Abstract
Although acute adverse effects on asthma have been frequently found for the U.S. Environmental Protection Agency's principal criteria air pollutants, there is little epidemiologic information on specific hydrocarbons from toxic emission sources. We conducted a panel study of 22 Hispanic children with asthma who were 10-16 years old and living in a Los Angeles community with high traffic density. Subjects filled out symptom diaries daily for up to 3 months (November 1999 through January 2000). Pollutants included ambient hourly values of ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide and 24-hr values of volatile organic compounds (VOCs), particulate matter with aerodynamic diameter < 10 microm (PM10, and elemental carbon (EC) and organic carbon (OC) PM10 fractions. Asthma symptom severity was regressed on pollutants using generalized estimating equations, and peak expiratory flow (PEF) was regressed on pollutants using mixed models. We found positive associations of symptoms with criteria air pollutants (O3, NO2, SO2, PM10), EC-OC, and VOCs (benzene, ethylbenzene, formaldehyde, acetaldehyde, acetone, 1,3-butadiene, tetrachloroethylene, toluene, m,p-xylene, and o-xylene). Selected adjusted odds ratios for bothersome or more severe asthma symptoms from interquartile range increases in pollutants were, for 1.4 ppb 8-hr NO2, 1.27 [95% confidence interval (CI), 1.05-1.54]; 1.00 ppb benzene, 1.23 (95% CI, 1.02-1.48); 3.16 ppb formaldehyde, 1.37 (95% CI, 1.04-1.80); 37 microg/m3 PM10, 1.45 (95% CI, 1.11-1.90); 2.91 microg/m3 EC, 1.85 (95% CI, 1.11-3.08); and 4.64 microg/m3 OC, 1.88 (95% CI, 1.12-3.17). Two-pollutant models of EC or OC with PM10 showed little change in odds ratios for EC (to 1.83) or OC (to 1.89), but PM10 decreased from 1.45 to 1.0. There were no significant associations with PEF. Findings support the view that air toxins in the pollutant mix from traffic and industrial sources may have adverse effects on asthma in children.
Full Text
The Full Text of this article is available as a PDF (183.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Buchdahl R., Willems C. D., Vander M., Babiker A. Associations between ambient ozone, hydrocarbons, and childhood wheezy episodes: a prospective observational study in south east London. Occup Environ Med. 2000 Feb;57(2):86–93. doi: 10.1136/oem.57.2.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chan-Yeung M., Chang J. H., Manfreda J., Ferguson A., Becker A. Changes in peak flow, symptom score, and the use of medications during acute exacerbations of asthma. Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):889–893. doi: 10.1164/ajrccm.154.4.8887581. [DOI] [PubMed] [Google Scholar]
- Delfino R. J., Coate B. D., Zeiger R. S., Seltzer J. M., Street D. H., Koutrakis P. Daily asthma severity in relation to personal ozone exposure and outdoor fungal spores. Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):633–641. doi: 10.1164/ajrccm.154.3.8810598. [DOI] [PubMed] [Google Scholar]
- Delfino R. J., Zeiger R. S., Seltzer J. M., Street D. H., Matteucci R. M., Anderson P. R., Koutrakis P. The effect of outdoor fungal spore concentrations on daily asthma severity. Environ Health Perspect. 1997 Jun;105(6):622–635. doi: 10.1289/ehp.97105622. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delfino R. J., Zeiger R. S., Seltzer J. M., Street D. H. Symptoms in pediatric asthmatics and air pollution: differences in effects by symptom severity, anti-inflammatory medication use and particulate averaging time. Environ Health Perspect. 1998 Nov;106(11):751–761. doi: 10.1289/ehp.98106751. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delfino Ralph J. Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research. Environ Health Perspect. 2002 Aug;110 (Suppl 4):573–589. doi: 10.1289/ehp.02110s4573. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delfino Ralph J., Zeiger Robert S., Seltzer James M., Street Donald H., McLaren Christine E. Association of asthma symptoms with peak particulate air pollution and effect modification by anti-inflammatory medication use. Environ Health Perspect. 2002 Oct;110(10):A607–A617. doi: 10.1289/ehp.021100607. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eid N., Yandell B., Howell L., Eddy M., Sheikh S. Can peak expiratory flow predict airflow obstruction in children with asthma? Pediatrics. 2000 Feb;105(2):354–358. doi: 10.1542/peds.105.2.354. [DOI] [PubMed] [Google Scholar]
- Enright P. L., Sherrill D. L., Lebowitz M. D. Ambulatory monitoring of peak expiratory flow. Reproducibility and quality control. Chest. 1995 Mar;107(3):657–661. doi: 10.1378/chest.107.3.657. [DOI] [PubMed] [Google Scholar]
- Ferguson A. C. Persisting airway obstruction in asymptomatic children with asthma with normal peak expiratory flow rates. J Allergy Clin Immunol. 1988 Jul;82(1):19–22. doi: 10.1016/0091-6749(88)90045-0. [DOI] [PubMed] [Google Scholar]
- Franklin P., Dingle P., Stick S. Raised exhaled nitric oxide in healthy children is associated with domestic formaldehyde levels. Am J Respir Crit Care Med. 2000 May;161(5):1757–1759. doi: 10.1164/ajrccm.161.5.9905061. [DOI] [PubMed] [Google Scholar]
- Garrett M. H., Hooper M. A., Hooper B. M., Rayment P. R., Abramson M. J. Increased risk of allergy in children due to formaldehyde exposure in homes. Allergy. 1999 Apr;54(4):330–337. doi: 10.1034/j.1398-9995.1999.00763.x. [DOI] [PubMed] [Google Scholar]
- Gielen M. H., van der Zee S. C., van Wijnen J. H., van Steen C. J., Brunekreef B. Acute effects of summer air pollution on respiratory health of asthmatic children. Am J Respir Crit Care Med. 1997 Jun;155(6):2105–2108. doi: 10.1164/ajrccm.155.6.9196122. [DOI] [PubMed] [Google Scholar]
- Goldberg S., Springer C., Avital A., Godfrey S., Bar-Yishay E. Can peak expiratory flow measurements estimate small airway function in asthmatic children? Chest. 2001 Aug;120(2):482–488. doi: 10.1378/chest.120.2.482. [DOI] [PubMed] [Google Scholar]
- Hagen J. A., Nafstad P., Skrondal A., Bjørkly S., Magnus P. Associations between outdoor air pollutants and hospitalization for respiratory diseases. Epidemiology. 2000 Mar;11(2):136–140. doi: 10.1097/00001648-200003000-00009. [DOI] [PubMed] [Google Scholar]
- Hankinson J. L., Odencrantz J. R., Fedan K. B. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999 Jan;159(1):179–187. doi: 10.1164/ajrccm.159.1.9712108. [DOI] [PubMed] [Google Scholar]
- Jennrich R. I., Schluchter M. D. Unbalanced repeated-measures models with structured covariance matrices. Biometrics. 1986 Dec;42(4):805–820. [PubMed] [Google Scholar]
- Kamps A. W., Roorda R. J., Brand P. L. Peak flow diaries in childhood asthma are unreliable. Thorax. 2001 Mar;56(3):180–182. doi: 10.1136/thorax.56.3.180. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kim Seongheon, Shen Si, Sioutas Constantinos. Size distribution and diurnal and seasonal trends of ultrafine particles in source and receptor sites of the Los Angeles basin. J Air Waste Manag Assoc. 2002 Mar;52(3):297–307. doi: 10.1080/10473289.2002.10470781. [DOI] [PubMed] [Google Scholar]
- Kinney Patrick L., Chillrud Steven N., Ramstrom Sonja, Ross James, Spengler John D. Exposures to multiple air toxics in New York City. Environ Health Perspect. 2002 Aug;110 (Suppl 4):539–546. doi: 10.1289/ehp.02110s4539. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Koren H. S., Graham D. E., Devlin R. B. Exposure of humans to a volatile organic mixture. III. Inflammatory response. Arch Environ Health. 1992 Jan-Feb;47(1):39–44. doi: 10.1080/00039896.1992.9935942. [DOI] [PubMed] [Google Scholar]
- Krzyzanowski M., Quackenboss J. J., Lebowitz M. D. Chronic respiratory effects of indoor formaldehyde exposure. Environ Res. 1990 Aug;52(2):117–125. doi: 10.1016/s0013-9351(05)80247-6. [DOI] [PubMed] [Google Scholar]
- Leikauf George D. Hazardous air pollutants and asthma. Environ Health Perspect. 2002 Aug;110 (Suppl 4):505–526. doi: 10.1289/ehp.02110s4505. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Malmberg L. P., Nikander K., Pelkonen A. S., Syvänen P., Koljonen T., Haahtela T., Turpeinen M. Acceptability, reproducibility, and sensitivity of forced expiratory volumes and peak expiratory flow during bronchial challenge testing in asthmatic children. Chest. 2001 Dec;120(6):1843–1849. doi: 10.1378/chest.120.6.1843. [DOI] [PubMed] [Google Scholar]
- Meltzer A. A., Smolensky M. H., D'Alonzo G. E., Harrist R. B., Scott P. H. An assessment of peak expiratory flow as a surrogate measurement of FEV1 in stable asthmatic children. Chest. 1989 Aug;96(2):329–333. doi: 10.1378/chest.96.2.329. [DOI] [PubMed] [Google Scholar]
- Mortimer K. M., Neas L. M., Dockery D. W., Redline S., Tager I. B. The effect of air pollution on inner-city children with asthma. Eur Respir J. 2002 Apr;19(4):699–705. doi: 10.1183/09031936.02.00247102. [DOI] [PubMed] [Google Scholar]
- Nel A. E., Diaz-Sanchez D., Li N. The role of particulate pollutants in pulmonary inflammation and asthma: evidence for the involvement of organic chemicals and oxidative stress. Curr Opin Pulm Med. 2001 Jan;7(1):20–26. doi: 10.1097/00063198-200101000-00004. [DOI] [PubMed] [Google Scholar]
- Norbäck D., Björnsson E., Janson C., Widström J., Boman G. Asthmatic symptoms and volatile organic compounds, formaldehyde, and carbon dioxide in dwellings. Occup Environ Med. 1995 Jun;52(6):388–395. doi: 10.1136/oem.52.6.388. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oberdörster G. Pulmonary effects of inhaled ultrafine particles. Int Arch Occup Environ Health. 2001 Jan;74(1):1–8. doi: 10.1007/s004200000185. [DOI] [PubMed] [Google Scholar]
- Ostro B., Lipsett M., Mann J., Braxton-Owens H., White M. Air pollution and exacerbation of asthma in African-American children in Los Angeles. Epidemiology. 2001 Mar;12(2):200–208. doi: 10.1097/00001648-200103000-00012. [DOI] [PubMed] [Google Scholar]
- Peden D. B. Mechanisms of pollution-induced airway disease: in vivo studies. Allergy. 1997;52(38 Suppl):37–58. doi: 10.1111/j.1398-9995.1997.tb04869.x. [DOI] [PubMed] [Google Scholar]
- Pekkanen J., Timonen K. L., Ruuskanen J., Reponen A., Mirme A. Effects of ultrafine and fine particles in urban air on peak expiratory flow among children with asthmatic symptoms. Environ Res. 1997;74(1):24–33. doi: 10.1006/enrs.1997.3750. [DOI] [PubMed] [Google Scholar]
- Penttinen P., Timonen K. L., Tiittanen P., Mirme A., Ruuskanen J., Pekkanen J. Number concentration and size of particles in urban air: effects on spirometric lung function in adult asthmatic subjects. Environ Health Perspect. 2001 Apr;109(4):319–323. doi: 10.1289/ehp.01109319. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peters A., Dockery D. W., Heinrich J., Wichmann H. E. Short-term effects of particulate air pollution on respiratory morbidity in asthmatic children. Eur Respir J. 1997 Apr;10(4):872–879. [PubMed] [Google Scholar]
- Peters A., Wichmann H. E., Tuch T., Heinrich J., Heyder J. Respiratory effects are associated with the number of ultrafine particles. Am J Respir Crit Care Med. 1997 Apr;155(4):1376–1383. doi: 10.1164/ajrccm.155.4.9105082. [DOI] [PubMed] [Google Scholar]
- Redline S., Wright E. C., Kattan M., Kercsmar C., Weiss K. Short-term compliance with peak flow monitoring: results from a study of inner city children with asthma. Pediatr Pulmonol. 1996 Apr;21(4):203–210. doi: 10.1002/(SICI)1099-0496(199604)21:4<203::AID-PPUL1>3.0.CO;2-P. [DOI] [PubMed] [Google Scholar]
- Romieu I., Meneses F., Ruiz S., Sienra J. J., Huerta J., White M. C., Etzel R. A. Effects of air pollution on the respiratory health of asthmatic children living in Mexico City. Am J Respir Crit Care Med. 1996 Aug;154(2 Pt 1):300–307. doi: 10.1164/ajrccm.154.2.8756798. [DOI] [PubMed] [Google Scholar]
- Sarnat J. A., Koutrakis P., Suh H. H. Assessing the relationship between personal particulate and gaseous exposures of senior citizens living in Baltimore, MD. J Air Waste Manag Assoc. 2000 Jul;50(7):1184–1198. doi: 10.1080/10473289.2000.10464165. [DOI] [PubMed] [Google Scholar]
- Sarnat J. A., Schwartz J., Catalano P. J., Suh H. H. Gaseous pollutants in particulate matter epidemiology: confounders or surrogates? Environ Health Perspect. 2001 Oct;109(10):1053–1061. doi: 10.1289/ehp.011091053. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schwartz J., Neas L. M. Fine particles are more strongly associated than coarse particles with acute respiratory health effects in schoolchildren. Epidemiology. 2000 Jan;11(1):6–10. doi: 10.1097/00001648-200001000-00004. [DOI] [PubMed] [Google Scholar]
- Segala C., Fauroux B., Just J., Pascual L., Grimfeld A., Neukirch F. Short-term effect of winter air pollution on respiratory health of asthmatic children in Paris. Eur Respir J. 1998 Mar;11(3):677–685. [PubMed] [Google Scholar]
- Shingo S., Zhang J., Reiss T. F. Correlation of airway obstruction and patient-reported endpoints in clinical studies. Eur Respir J. 2001 Feb;17(2):220–224. doi: 10.1183/09031936.01.17202200. [DOI] [PubMed] [Google Scholar]
- Sly P. D., Cahill P., Willet K., Burton P. Accuracy of mini peak flow meters in indicating changes in lung function in children with asthma. BMJ. 1994 Feb 26;308(6928):572–574. doi: 10.1136/bmj.308.6928.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson A. J., Shields M. D., Patterson C. C. Acute asthma exacerbations and air pollutants in children living in Belfast, Northern Ireland. Arch Environ Health. 2001 May-Jun;56(3):234–241. doi: 10.1080/00039890109604447. [DOI] [PubMed] [Google Scholar]
- Thurston G. D., Lippmann M., Scott M. B., Fine J. M. Summertime haze air pollution and children with asthma. Am J Respir Crit Care Med. 1997 Feb;155(2):654–660. doi: 10.1164/ajrccm.155.2.9032209. [DOI] [PubMed] [Google Scholar]
- Timonen K. L., Pekkanen J. Air pollution and respiratory health among children with asthmatic or cough symptoms. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):546–552. doi: 10.1164/ajrccm.156.2.9608044. [DOI] [PubMed] [Google Scholar]
- Tolbert P. E., Klein M., Metzger K. B., Peel J., Flanders W. D., Todd K., Mulholland J. A., Ryan P. B., Frumkin H. Interim results of the study of particulates and health in Atlanta (SOPHIA). J Expo Anal Environ Epidemiol. 2000 Sep-Oct;10(5):446–460. doi: 10.1038/sj.jea.7500106. [DOI] [PubMed] [Google Scholar]
- Vedal S., Petkau J., White R., Blair J. Acute effects of ambient inhalable particles in asthmatic and nonasthmatic children. Am J Respir Crit Care Med. 1998 Apr;157(4 Pt 1):1034–1043. doi: 10.1164/ajrccm.157.4.9609008. [DOI] [PubMed] [Google Scholar]
- Verschelden P., Cartier A., L'Archevêque J., Trudeau C., Malo J. L. Compliance with and accuracy of daily self-assessment of peak expiratory flows (PEF) in asthmatic subjects over a three month period. Eur Respir J. 1996 May;9(5):880–885. doi: 10.1183/09031936.96.09050880. [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]
- Weisel Clifford P. Assessing exposure to air toxics relative to asthma. Environ Health Perspect. 2002 Aug;110 (Suppl 4):527–537. doi: 10.1289/ehp.02110s4527. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wieslander G., Norbäck D., Björnsson E., Janson C., Boman G. Asthma and the indoor environment: the significance of emission of formaldehyde and volatile organic compounds from newly painted indoor surfaces. Int Arch Occup Environ Health. 1997;69(2):115–124. doi: 10.1007/s004200050125. [DOI] [PubMed] [Google Scholar]
- Yu O., Sheppard L., Lumley T., Koenig J. Q., Shapiro G. G. Effects of ambient air pollution on symptoms of asthma in Seattle-area children enrolled in the CAMP study. Environ Health Perspect. 2000 Dec;108(12):1209–1214. doi: 10.1289/ehp.001081209. [DOI] [PMC free article] [PubMed] [Google Scholar]