The Chattanooga school children study: effects of community exposure to nitrogen dioxide. II. Incidence of acute respiratory illness.
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Biomedical subjects
Publications and source records attributed to C M Shy.
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This Six Communities Study conducted at six communities in southwestern North Carolina investigates the respiratory health status of residents whose households are located near an incinerator. This diary study makes it possible to estimate the daily variation of pulmonary function measured as peak expiratory flow rate (PEFR) related to 24-h mean PM10 levels, which were observed at each monitoring station placed in the six study communities, as a surrogate exposure measure of outdoor air pollution. Observations of PEFR among participants in each community were analyzed to determine how they varied according to the degree of exposure to ambient pollutants as well as to other cofactors including, sex, age, respiratory hypersensitivity, hours spent outdoors within the area of the selected community, and surrogate measures for indoor air pollution exposure (vacuum use and experience of air irritants at work). The findings revealed that respiratory hypersensitivity status is a predictor of declining PEFR. PM10 concentrations measured in each study area did not seem to be related to the variations of respiratory health as measured by PEFR. This study did not show any difference in respiratory health between subjects of an incinerator community and those of its comparison community. Even though this community-based study with free-living subjects shows negative findings on the relationship between respiratory health and PM10, it is worth noting that these findings must be interpreted cautiously because exposure estimation based on monitoring of ambient air likely results in misclassification of true exposure levels.
Lack of daily data on airborne particles has been a common problem in an air pollution research. To deal with this problem, a regression model was developed to estimate daily PM10 concentration using visibility in Bangkok from 1992 to 1997, based on 1092 visibility/PM10 pair-observations on low humidity days (humidity < or = 76.5%). Visibility was significantly and inversely associated with PM10 (r = 0.71), after adjusting for minimum temperature and winter indicator variable. The R2 of the model was 0.51.
The incidence and severity of acute respiratory disease was studied in families in three New York communities with different ambient levels of SO2 and particulate air pollution. Upper, lower, and total respiratory disease rates in fathers, mothers, and school children tended to be higher in the communities with higher pollution levels. Similar higher rates, however, were not observed among preschool children. Regression analyses were used to adjust rates for socioeconomic status, parental smoking, chronic bronchitis in parents, and possible indoor pollution resulting from the use of a gas stove for cooking. After these adjustments the community differences were still significant (P less than .01), for schoolchildren. The indoor pollution related to gas stoves was a significant covariate among children. The effects of smoking were inconsistent. It was not possible to attribute the higher rates observed to any specific pollutant, since both SO2 and particulate matter levels were higher in the high pollution communities, nor was it possible to attribute the excesses to current levels of exposure or to a residual effect of previous higher exposure concentrations. The fact that young children did not follow the pattern suggests the latter. It was concluded, however, that current or previous exposures to the complexity of air pollutants in New York City was at least partially responsible for increased incidences of acute respiratory disease.
A case-control study utilizing vital records and ecologic, surrogate exposure measures was conducted in Iowa and Michigan. The study hypothesis anticipated an excess risk of clefts among fetuses exposed during the peak agricultural chemical use period (April through November) coincident with their first trimester of gestation. To examine this hypothesis, multiple regression techniques were used to aid identification of potential confounders; additional analyses, stratified on the potential confounders, were performed using two chemical exposure indices. The major findings of these analyses suggest: (1) an agricultural chemical effect (using the multiple exposure index) controlling for season of conception; (2) no independent effect of season of conception (thus the null hypothesis is not rejected); and (3) little chemical/season interaction. These results imply that if exposures to agricultural chemicals are, in fact, risk factors for clefts, an expanded model that accounts for multiple pesticidal exposures may be more sensitive than consideration of season of exposure, as originally hypothesized.
The incidence of acute respiratory illness in families in Chattanooga, Tennessee was studied in 1972 and 1973 to determine if residents of a formerly high nitrogen dioxide exposure community continued to experience a high incidence of illness after ambient air concentrations of the pollutant had been reduced substantially. Illness data were collected by telephone at 2-wk intervals and illness rates per 100 person weeks of observation were contrasted with air pollution concentrations measured no more than 3.2 km from the home. Data were contrasted by communities designated as high, intermediate, or low pollution exposure. In 1972, higher rates of respiratory illness continued to occur in the designated high pollution area. These were associated with current higher short-term concentrations of nitrogen dioxide even though the long-term mean concentrations of the pollutant were little higher than those in the low pollution area. It was not possible to attribute the excesses in illness to specific pollutants or to specific exposure periods. However, reduction of the illness rate in 1973 associated with a strike at the primary source industry that curtailed nitrogen dioxide pollution in the high exposure community suggested that the short-term exposure may be more important than long-term exposure.
The purpose of the study presented here was to simultaneously measure air quality and respiratory function and symptoms in populations living in the neighborhood of waste incinerators and to estimate the contribution of incinerator emissions to the particulate air mass in these neighborhoods. We studied the residents of three communities having, respectively, a biomedical and a municipal incinerator, and a liquid hazardous waste-burning industrial furnace. We compared results with three matched-comparison communities. We did not detect differences in concentrations of particulate matter among any of the three pairs of study communities. Average fine particulate (PM2.5) concentrations measured for 35 days varied across study communities from 16 to 32 micrograms/m3. Within the same community, daily concentrations of fine particulates varied by as much as eightfold, from 10 to 80 micrograms/m3, and were nearly identical within each pair of communities. Direct measurements of air quality and estimates based on a chemical mass balance receptor model showed that incinerator emissions did not have a major or even a modest impact on routinely monitored air pollutants. A onetime baseline descriptive survey (n = 6963) did not reveal consistent community differences in the prevalence of chronic or acute respiratory symptoms between incinerator and comparison communities, nor did we see a difference in baseline lung function tests or in the average peak expiratory flow rate measured over a period of 35 days. Based on this analysis of the first year of our study, we conclude that we have no evidence to reject the null hypothesis of no acute or chronic respiratory effects associated with residence in any of the three incinerator communities.