Respiratory Health Risks for Children Living Near a Major Railyard

Assessing environmental injustice in Kansas City by linking paediatric asthma to local sources of pollution: a cross-sectional study

OBJECTIVE

A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.

DESIGN

This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall's τ correlation and multivariable Poisson regression models.

SETTING

We used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.

PARTICIPANTS

Patients with 2+ asthma encounters during the EPA study timeframe were identified.

RESULTS

Residential distance from railyards exhibited a significant negative correlation with overall (-0.36 (CI -0.41 to -0.32)) and acute (-0.27 (CI -0.32 to -0.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3 km was associated with a decrease in overall asthma rates of 26%.

CONCLUSION

Significant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.

Chronic Absenteeism: Risks and Protective Factors Among Low-Income, Minority Children and Adolescents

BACKGROUND

Low-income and racial/ethnic minority students often face distinct challenges in attending school eading to lower academic performance, low graduation rates, and overall, an indicator of diminished long-term social and financial stability. Chronic absenteeism is a national problem and to address this, a better understanding of risks and points of intervention for the students most at risk is needed. This cross-sectional study sought to assess risks and protective factors associated with chronic absenteeism in a predominantly low-income minority school district in Southern.

METHODS

Conducted in southern California, students (N = 24,439) ages 9 to 21 years were recruited. A logistic regression was used to assess the role poor physical and mental health, safety, bullying, and family risk factors attributed to chronic absenteeism.

RESULTS

Results revealed that asthma (odds ratio [OR] = 1.35, p < .001), being overweight/obese (OR = 1.38, p < .01), presence of family risk factors (OR = 1.49, p < .001), bullying (OR = 0.84, p < .05) and perceptions of safety at school (OR = 1.24, p < .05) increased the odds of chronic absenteeism, while protective factors such as support (OR = 1.30, p < .001), increased sleep (OR = 0.96, p < .001) and positive growth mindset (OR = 0.96, p < .001), mitigated it.

CONCLUSION

This study not only identifies risk but protective factors worth adhering to, to promote school attendance. Future research should further examine the role of mental health in chronic absenteeism.

Association of major California freight railyards with asthma-related pediatric emergency department hospital visits

Asthma is a major health threat and leading cause of chronic morbidity among children. Air pollutants have been linked to exacerbations and promotion of initial development of asthma. Extensive research already conducted assessing adverse health impacts associated with exposure to pollutants from vehicular traffic. However, little research conducted assessing exposure to pollutants stemming from goods movement industry, such as freight railyards. This study's purpose to assess potential association between residential proximity to major freight railyards and asthma-related emergency room (ER) visits in children. This study included children ≤14 yrs. old, living within 30-mile radius of one of 18 freight railyards in California, and having utilized emergency room services between 2007 and 2009, identified through California Office of Statewide Health Planning and Development (OSHPD) database. Logistic regression modeling with all 18 railyards, and models with top 5 polluting railyards, conducted to assess for potential association between asthma related ER visit (asthma vs. non-asthma visit) and railyard residential proximity. A total 109,645 asthma related ER visits identified, majority among low income, minority populations. Within 18 railyard model, children closest to railyard (0-5 miles) were at significant increased odds (OR = 1.15, 95%CI: 1.10-1.20) for asthma related ER visit and stronger odds observed for 5 top emitting railyards (OR = 1.40, 95%CI: 1.29-1.52). Our findings indicate a strong link between asthma ER visits for children and residential proximity to railyards, especially among low-income and minority communities. There's a critical need to better understand complex health risks for individuals residing in these communities and mitigation efforts for this vulnerable population.

Impact of air pollution on cause-specific mortality in Korea: Results from Bayesian Model Averaging and Principle Component Regression approaches

Health effects related to air pollution are a major global concern. Related studies based on reliable exposure assessment methods would potentially enable policy makers to propose appropriate environmental management policies. In this study, integrated Bayesian Model Averaging (BMA) and Principle Component Regression (PCR) were adopted to assess the severity of air pollution impacts on mortality related to circulatory, respiratory and skin diseases in 25 districts of Seoul, South Korea for the years 2005-2015. These methods were consistent in determining the best regression models and most important pollutants related to mortality in those highly susceptible to poor air quality. Specifically, the results demonstrated that pneumonia was highly associated with air pollution, with a large determination coefficient (BMA: 0.46, PCR: 0.51) and high model's posterior probability (0.47). The most reliable prediction model for pneumonia was indicated by the lowest Bayesian Information Criterion. Among the pollutants, particulate matter with an aerodynamic diameter of 10 μm or less (PM₁₀) was associated with serious health risks on evaluation, with the highest posterior inclusion probabilities (range, 80.20 to 100.00%) and significantly positive correlation coefficients (range, 0.14 to 0.34, p < 0.05). In addition, excessive PM₁₀ concentration (approximately 2.54 times the threshold) and a continuous increase in mortality due to respiratory diseases (approximately 1.50-fold in 10 years) were also exhibited. Overall, the results of this study suggest that currently, socio-environmental policies and international collaboration to mitigate health effects of air pollution is necessary in Seoul, Korea. Moreover, consideration of uncertainty of the regression model, which was verified in this research, will facilitate further application of this approach and enable optimal prediction of interactions between human and environmental factors.

Comparison of normal and dusty day impacts on fractional exhaled nitric oxide and lung function in healthy children in Ahvaz, Iran

Children are the vulnerable group at risk of adverse health effects related to air pollution due to dust storm in Ahvaz. The purpose of this study was to compare the values of fractional exhaled nitric oxide (FENO) and lung functions as parameters of adverse health effects of particulate matter (PM) in dusty and normal (non-dusty) days in elementary schoolchildren. The study was conducted among elementary school students in Ahvaz. The healthy elementary schoolchildren (N = 105) were selected from different districts for FENO and lung function sampling during the dusty and normal days. The values of PM₁₀ and PM_2.5 during dusty days were higher than during normal days. Mean values of FENO during the normal and dusty days were 14.23 and 20.3 ppb, respectively, and the difference between these values was statistically significant (p < 0.05). Lung function results showed a statistically significant difference between the mean values of forced vital capacity during the dusty and normal days (p < 0.05). The results revealed a significant difference both in the values of inflammatory biomarker and in the lung function tests in dusty and normal days. Based on our results, fractional exhaled nitric oxide could be a useful short-term biomarker of particulate pollution effect coupled with spirometry.