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