Global goods movement and the local burden of childhood asthma in southern California.
ABSTRACT As part of a community-based participatory research effort, we estimated the preventable burden of childhood asthma associated with air pollution in the southern California communities of Long Beach and Riverside.
We calculated attributable fractions for 2 air pollution reduction scenarios to include assessment of the newly recognized health effects associated with residential proximity to major roads and impact from ship emissions.
Approximately 1600 (9%) of all childhood asthma cases in Long Beach and 690 (6%) in Riverside were attributed to traffic proximity. Ship emissions accounted for 1400 (21%) bronchitis episodes and, in more modest proportions, health care visits for asthma. Considerably greater reductions in asthma morbidity could be obtained by reducing nitrogen dioxide and ozone concentrations to levels found in clean coastal communities.
Both Long Beach and Riverside have heavy automobile traffic corridors as well as truck traffic and regional pollution originating in the Los Angeles-Long Beach port complex, the largest in the United States. Community-based quantitative risk analyses can improve our understanding of health problems and help promote public health in transportation planning.
Full-textDOI: · Available from: Fred Lurmann, May 28, 2015
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ABSTRACT: Emerging evidence suggests that near-roadway air pollution (NRP) exposure causes childhood asthma. The associated costs are not well documented. We estimated the cost of childhood asthma attributable to residential NRP exposure and regional ozone (O3) and nitrogen dioxide (NO2) levels in Los Angeles County. We developed a novel approach to apportion the costs between these exposures under different pollution scenarios. We integrated results from a study of willingness to pay to reduce the burden of asthma with results from studies of health care use and charges to estimate the costs of an asthma case and exacerbation. We applied those costs to the number of asthma cases and exacerbations caused by regional pollution in 2007 and to hypothetical scenarios of a 20% reduction in regional pollution in combination with a 20% reduction or increase in the proportion of the total population living within 75 m of a major roadway. Cost of air pollution-related asthma in Los Angeles County in 2007 was $441 million for O3 and $202 million for NO2 in 2010 dollars. Cost of routine care (care in absence of exacerbation) accounted for 18% of the combined NRP and O3 cost and 39% of the combined NRP and NO2 cost; these costs were not recognized in previous analyses. NRP-attributable asthma accounted for 43% (O3) to 51% (NO2) of the total annual cost of exacerbations and routine care associated with pollution. Hypothetical scenarios showed that costs from increased NRP exposure might offset savings from reduced regional pollution. Our model disaggregates the costs of regional pollution and NRP exposure and illustrates how they might vary under alternative exposure scenarios. The cost of air pollution is a substantial burden on families and an economic loss for society. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.Journal of Allergy and Clinical Immunology 11/2014; 134(5):1028-35. DOI:10.1016/j.jaci.2014.09.029 · 11.25 Impact Factor
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ABSTRACT: http://ac.els-cdn.com/S0891584912010052/1-s2.0-S0891584912010052-main.pdf?_tid=cf831eda-e0e3-11e3-890d-00000aab0f6c&acdnat=1400675659_033e43ac55cebcb1d186327901996198Air Quality Atmosphere & Health 05/2014; 7(4). DOI:10.1007/s11869-014-0265-8 · 1.46 Impact Factor
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ABSTRACT: Inland southern California is a region of public health concern, especially for children, given the area's perennially poor air quality and increasing sources of local pollution. One elementary school specifically is located only a few hundred yards from the San Bernardino Railyard, one of the busiest goods movement facilities in California, potentially increasing respiratory problems. Through ENRRICH (Environmental Railyard Research Impacting Community Health) Project, we assessed association of proximity to a major freight railyard on adverse respiratory health in schoolchildren. Respiratory screening was provided for children at two elementary schools: one near the railyard and a socio-demographically matched comparison school 7 miles away. Screening included testing for airway inflammation (FE NO), lung function (peak expiratory flow, PEF) and parent reported respiratory symptoms. Parental questionnaires collected additional information. Log-binomial and linear regression assessed associations. Children attending school near the railyard were more likely to exhibit airway obstruction with higher prevalence of abnormal PEF (<80 %): prevalence ratio (PR) = 1.59 (95 % CI 1.19-2.12). The association with inflammation was less clear. Children at the exposure school, who had lived 6 months or longer at their current address (vs. all children at that school) were more likely to have values suggesting inflammation (FE NO > 20 ppb) (PR = 1.44, 95 % CI 1.02-2.02) and present with a trend for increased adverse respiratory symptoms. Children attending school near the railyard were significantly more likely to display respiratory health challenges. Ideally these low-income, low resource communities should be supported to implement sustainable intervention strategies to promote an environment where children can live healthier and thrive.Journal of Community Health 04/2015; DOI:10.1007/s10900-015-0026-0 · 1.28 Impact Factor