Pediatric Emergency Visits and Short-Term Changes in PM 2.5 Concentrations in the U.S. State of Georgia

Matthew J. Strickland, Hua Hao, Xuefei Hu, Howard H. Chang, Lyndsey A. Darrow, Yang Liu
2016 Environmental Health Perspectives  
Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM 2.5 ) have been reported in previous studies, although few were performed in nonmetropolitan areas. oBjective: We estimated associations between daily PM 2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state
more » ... of Georgia by urbanicity classification. Methods: We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM 2.5 estimates and admission dates during 1 January 2002-30 June 2010 for 2-to 18-year-olds for asthma or wheeze (n = 189,816), and for 0-to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code-level estimates of 24-hr average PM 2.5 were calculated by averaging concentrations within ZIP code boundaries. We used timestratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM 2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity. results: A 10-μg/m 3 increase in same-day PM 2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM 2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant. conclusion: Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM 2.5 concentrations in Georgia. citation: Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric emergency visits and short-term changes in PM 2.5 concentrations in the U.S. state of Georgia. Environ Health Perspect 124:690-696; http://dx.
doi:10.1289/ehp.1509856 pmid:26452298 pmcid:PMC4858390 fatcat:vsjhzy7cvjbg3m7odj6ii2imoa