Air Pollution and Acute Respiratory Response in a Panel of Asthmatic Children along the U.S.-Mexico Border
Sarnat, Stefanie Ebelt, Raysoni, Amit U., Li, Wen-Whai, Holguin, Fernando, Johnson, Brent A., Luevano, Silvia Flores, Garcia, Jose Humberto, Sarnat, Jeremy A., Environmental Health Perspectives
BACKGROUND: Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.-Mexico border because of rapid population growth near busy border highways and roads.
OBJECTIVES: We conducted the first binational study of the impacts of air pollution on asthmatic children in Ciudad Juarez, Mexico, and El Paso, Texas, USA, and compared different exposure metrics to assess acute respiratory response.
METHODS: We recruited 58 asthmatic children from two schools in Ciudad Juarez and two schools in El Paso. A marker of airway inflammation [exhaled nitric oxide (eNO)], respiratory symptom surveys, and pollutant measurements (indoor and outdoor 48-hr size-fractionated particulate matter, 48-hr black carbon, and 96-hr nitrogen dioxide) were collected at each school for 16 weeks. We examined associations between the pollutants and respiratory response using generalized linear mixed models.
RESULTS: We observed small but consistent associations between eNO and numerous pollutant metrics, with estimated increases in eNO ranging from 1% to 3% per interquartile range increase in pollutant concentrations. Effect estimates from models using school-based concentrations were generally stronger than corresponding estimates based on concentrations from ambient air monitors. Both traffic-related and non -- traffic-related particles were typically more robust predictors of eNO than was nitrogen dioxide, for which associations were highly sensitive to model specification. Associations differed significantly across the four school-based cohorts, consistent with heterogeneity in pollutant concentrations and cohort characteristics. Models examining respiratory symptoms were consistent with the null.
CONCLUSIONS: The results indicate adverse effects of air pollution on the subclinical respiratory health of asthmatic children in this region and provide preliminary support for the use of air pollution monitors close to schools to track exposure and potential health risk in this population.
KEY WORDS: air pollution, asthma, children, exposure assessment, fine particulate matter, nitrogen dioxide, ozone. Environ Health Perspect 120:437-444 (2012). http://dx.doi.org/10.1289/ ehp. 1003169 [Online 6 September 2011 ]
The impact of urban air pollution on asthmatic children has been a long-standing environmental health concern. For the U.S.-Mexico border region, this concern is pronounced because of rapid population growth near busy border highways and roads. Collectively, the total population living along the U.S.-Mexico border is approximately 12 million, a figure expected to double by 2030 (Peach and Williams 2004). Commensurate with this demographic change has been an increase in binational commerce along the border since the implementation of the North American Free Trade Agreement. Together, these trends have led to increases in the total number of international border crossings of gasoline and diesel motor vehicles, traffic congestion, and corresponding idling times at the crossings (Currey et al. 2005). The Paso del Norte (PdN) region, encompassing the metropolitan areas of Ciudad Juarez, Mexico (CJ), and El Paso, Texas, USA (EP), warrants specific attention, being one of the two busiest border crossing regions along the entire U.S.-Mexico border (Bureau of Transportation Statistics 2009), with 14-17 million annual vehicle border crossings at five separate locations.
Previous studies conducted in the PdN region report elevated traffic-related and nontraffic-related pollutant concentrations (e.g., Li et al. 2001). A recent critical review of the literature found sufficient evidence to support a causal relationship between traffic-related air pollution exposure and asthma exacerbation, particularly in asthmatic children (Health Effects Institute 2010). Results from an earlier study in CJ were consistent with this evidence base, with associations observed between road and traffic densities and airway inflammation in asthmatic children (Holguin et al. …