Asthma Hospital Admissions and Ambient Air Pollutant Concentrations in New York City


Air pollution is considered a risk factor for asthma. In this paper, we analyze the association between daily hospital admissions for asthma and ambient air pollution concentrations in four New York City counties. Negative binomial regression is used to model the association between daily asthma hospital admissions and ambient air pollution concentrations. Potential confounding factors such as heat index, day of week, holidays, yearly population changes, and seasonal and long-term trends are controlled for in the models. Nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO) show the most consistent statistically significant associations with daily hospitalizations for asthma during the entire period (1996-2000). The associations are stronger for children (0 - 17 years) than for adults (18 - 64 years). Relative risks (RR) for the inter-quartile range (IQR) of same day 24-hour average pollutant concentration and asthma hospitalizations for children for the four county hospitalization totals were: NO2 (IQR = 0.011 ppm, RR = 1.017, 95% CI = 1.001, 1.034), SO2 (IQR = 0.008 ppm, RR = 1.023, 95% CI = 1.004, 1.042), CO (IQR = 0.232 ppm, RR = 1.014, 95% CI = 1.003, 1.025). In the case of ozone (O3) and particulate matter (PM2.5) statistically significant associations were found for daily one-hour maxima values and children’s asthma hospitalization in models that used lagged values for air pollution concentrations. Five-day weighted average lag models resulted in these estimates: O3 (one-hour maxima) (IQR = 0.025 ppm, RR = 1.049, 95% CI = 1.002, 1.098), PM2.5 (one-hour maxima) (IQR = 16.679 μg/m3, RR = 1.055, 95% CI = 1.008, 1.103). In addition, seasonal variations were also explored for PM2.5 and statistically significant associations with daily hospital admissions for asthma were found during the colder months (November-March) of the year. Important differences in pollution effects were found across pollutants, counties, and age groups. The results for PM2.5 suggest that the composition of PM is important to this health outcome, since the major sources of NYC PM differ between winter and summer months.

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C. Restrepo, J. Simonoff, G. Thurston and R. Zimmerman, "Asthma Hospital Admissions and Ambient Air Pollutant Concentrations in New York City," Journal of Environmental Protection, Vol. 3 No. 9A, 2012, pp. 1102-1116. doi: 10.4236/jep.2012.329129.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Centers for Disease Control (CDC), “Asthma,” 2010.
[2] R. J. Pandya, G. Solomon, A. Kinner, J. R. Balmes, “Diesel Exhaust and Asthma: Hypotheses and Molecular Mechanisms of Action,” Environmental Health Perspectives, Vol. 110, Suppl. 1, 2002, pp. 103-112. doi:10.1289/ehp.02110s1103
[3] R. C. Gwynn, G. D. Thurston, “The burden of air pollution: Impacts in racial minorities,” Environmental Health Perspectives, Vol. 109, Suppl. 4, 2001, pp. 501-506. doi:10.1289/ehp.01109s4501
[4] D. E. McLean, S. Bowen, K. Drezner, A. Rowe, P. Sherman, S. Schroeder, K. Redlener, I. Redlener, “Asthma Among Homeless Children,” Archives of Pediatrics and Adolescent Medicine, Vol. 158, 2004, pp. 244-249. doi:10.1001/archpedi.158.3.244
[5] New York City Department of Health and Mental Hygiene, “Air Pollution and the Health of New Yorkers: The Impact of Fine Particles and Ozone,” 2011.
[6] J. M. Samet, J. J. K. Jaakkola, “The Epidemiologic Approach to Investigating Outdoor Air Pollution,” In: Holgate ST, Samet JM, Koren HS, Maynard RL, Eds., Air Pollution and Health, Academic Press, New York, 1999, pp. 431-459.doi:10.1016/B978-012352335-8/50095-8
[7] M. Jerrett, K. Shankardass, K. Berhane, W. J. Gauderman, N. Künzli, E. Avol, F. Gilliland, F. Lurmann, J. N. Molitor, J. T. Molitor, D. C. Thomas, J. Peters, R. McConnell, “Traffic-Related Air Pollution and Asthma Onset in Children: A Prospective Cohort Study with Individual Exposure Measurement,” Environmental Health Perspectives Vol. 116, No. 10, 2008, pp. 1433–1438. doi:10.1289/ehp.10968
[8] F. Castro-Giner, N. Künzli, B. Jacquemin, B. Forsberg, R. de Cid, J. Sunyer, D. Jarvis, D. Briggs, D. Vienneau, D. Norback, J. R. González, S. Guerra, C. Janson, J. M. Antó, M. Wjst, J. Heinrich, X, Estivill, M. Kogevinas, “Traffic-Related Air Pollution, Oxidative Stress Genes, and Asthma (ECHRS),” Environmental Health Perspectives, Vol. 117, No. 12, 2009, pp. 1919–1924.doi:10.1289/ehp.0900589
[9] N. A. Clark, P. A. Demers, C. J. Karr, M. Koehoorn, C. Lencar, L. Tamburic, M. Brauer, “Effect of Early Life Exposure to Air Pollution on Development of Childhood Asthma,” Environmental Health Perspectives, Vol. 118, No. 2, 2010, pp. 284–290. doi:10.1289/ehp.0900916
[10] S. Redd, “Asthma in the United States: Burden and Current Theories,” Environmental Health Perspectives, Vol. 110, Suppl. 4, 2002, pp. 557-560.doi:10.1289/ehp.02110s4557
[11] H. S. Koren, “Associations between Criteria Air Pollutants and Asthma,” Environmental Health Perspectives, Vol. 103, Suppl. 6, 1995, pp. 235-242.doi:10.1289/ehp.95103s6235
[12] D. V. Bates, “Observations on Asthma,” Environmental Health Perspectives, Vol. 103, Suppl. 6, 1995, pp. 243-247. doi:10.1289/ehp.95103s6243
[13] G. W. K. Wong, T. F. Leung, T. F. Fok, “Outdoor Air Pollution and Asthma,” Pediatric Pulmonology, Suppl. 26, 2004, pp. 220–222. doi:10.1002/ppul.70111
[14] L. Tzivian, “Outdoor Air Pollution and Asthma in Children,” Journal of Asthma, Vol. 48, No. 5, 2011, pp. 470–481. doi:10.3109/02770903.2011.570407
[15] G. Norris, S. N. YoungPong, J. Q. Koenig, T. V. Larson, L. Sheppard,J. W. Stout, “An Association between Fine Particles and Asthma Emergency Department Visits for Children in Seattle,” Environmental Health Perspectives, Vol. 107, No. 6, 1999, pp. 489-493. doi:10.1289/ehp.99107489
[16] M. Lin, Y. Chen, R. T. Burnett, P. J. Villeneuve, D. Krewski, “Effect of short-term exposure to gaseous pollution on asthma hospitalisation in children: a bi-directional case-crossover analysis,” Journal of Epidemiology and Community Health, Vol. 57, 2003, pp. 50–55.doi:10.1136/jech.57.1.50
[17] K. Ito, G. D. Thurston, R. A. Silverman, “Characterization of PM2.5, Gaseous Pollutants, and Meteorological Interactions in the Context of Time-Series Health Effects Models,” Journal of Exposure Science and Environmental Epidemiology, Vol. 17, 2007, pp. S45-S60.
[18] I. F. Goldstein, J. Cuzick, “Daily Patterns of Asthma in New York City and New Orleans: An Epidemiologic Investigation,” Environmental Research, Vol. 30, 1983, pp. 211-223. doi:10.1016/0013-9351(83)90181-0
[19] I. F. Goldstein, B. Currie, “Seasonal Patterns of Asthma: A Clue to Etiology,” Environmental Research, Vol. 33, 1984, pp. 201-215. doi:10.1016/0013-9351(84)90017-3
[20] L. Greenburg, F. Field, J. I. Reed, C. L. Erhardt, “Asthma and Temperature Change,” Archives of Environmental Health, Vol. 8, 1964, pp. 642-647.
[21] L. Greenburg, F. Field, J. I. Reed, C. L. Erhardt, “Asthma and Temperature Change,” Archives of Environmental Health, Vol. 12, 1966, pp. 561-563.
[22] I. F. Goldstein, E. Dulberg, “Air pollution and asthma: Search for a relationship,” Journal of Air Pollution Control Association, Vol. 31, 1981, pp. 370. doi:10.1080/00022470.1981.10465231
[23] G. D. Thurston, K. Ito, P. L. Kinney, M. Lippmann, “A Multi-Year Study of Air Pollution and Respiratory Hospital Admissions in Three New York State Metropolitan Areas: Results for 1988 and 1989 Summers,” Journal of Exposure Analysis and Environmental Epidemiology, Vol. 2, No. 4, 1992, pp. 429-450.
[24] P. F. Jameson, L. S. Kalkstein, P. J. Gergen, “A Synoptic Evaluation of Asthma Hospital Admissions in New York City,” American Journal of Respiratory and Critical Care Medicine, Vol. 156, 1997, pp. 1781-1788.
[25] R. C. Gwynn, “A Time-Series Analysis of Mortality and Hospital Admissions Associations with Particulate Matter Air Pollution Components in Two New York Metropolitan Areas,” Ph.D. dissertation, New York University, New York, 1999.
[26] R. Lall, K. Ito, G. D. Thurston, “Distributed Lag Analyses of Daily Hospital Admissions and Source?Apportioned Fine Particle Air Pollution,” Environmental Health Perspectives,Vol. 119, No. 4, 2011, pp. 455-60.
[27] National Oceanic and Atmospheric Administration (NOAA). “Climate-Radar Data Inventories,” 2012.
[28] S. R. Schmitt, “Heat Index Calculator,” 2004.
[29] J. S. Simonoff, “Analyzing Categorical Data,” Springer Texts in Statistics, Springer-Verlag, New York, 2003.
[30] W. N. Venables, B. D. Ripley, “Modern Applied Statistics with S,” Springer-Verlag, New York, 2002.
[31] Insightful Corporation. “S-Plus version 6.1,” 2001.
[32] J. M. Samet, S. L. Zeger, F. Dominici, F. Curriero, I. Coursac, D. W. Dockery, J. Schwartz, A. Zanabetti, “The National Morbidity, Mortality, and Air Pollution Study Part I: Methods and Methodologic Issues,” Health Effects Institute (HEI), 2000.
[33] J. S. Hwang, T. H. Hu, C. C. Chan, “Air Pollution Mix and Emergency Room Visits for Respiratory and Cardiac Diseases in Taipei,” Journal of Data Science, Vol. 2, 2004, pp. 311-327.
[34] M. Lin, Y. Chen, P. J. Villeneuve, R. T. Burnett, L. Lemyre, C. Hertzman, K. M. McGrail, D. Krewski, “Gaseous Air Pollutants and Asthma Hospitalization of Children with Low Household Income in Vancouver, British Columbia, Canada,” American Journal of Epidemiology, Vol. 159, 2004, pp. 294-303. doi:10.1093/aje/kwh043
[35] K. Demerjian, “EPA PM Supersite Final Report: PM2.5 Technology Assessment and Characterization Study in New York State (PMTACS-NY),” 2004.
[36] R. Lall, G. D. Thurston, “Identifying and quantifying transported vs. local sources of New York City PM2.5 fine particulate matter air pollution,” Atmospheric Environment, Vol. 40, Suppl. 2, 2006, pp. 333–46. doi:10.1016/j.atmosenv.2006.04.068
[37] C. A. Pope III, D. W., “Epidemiology of Particle Effects,” In: S. T. Holgate, J. M. Samet, H. S. Koren, R. L. Maynard, Air Pollution and Health, Academic Press, New York, 1999, pp. 673-705.
[38] T. J. Grahame, “Does improved exposure information for PM2.5 constituents explain differing results among epidemiological studies?” Inhalation Toxicology, Vol. 21, No. 5, 2009, pp. 381-93. doi:10.1080/08958370802380495
[39] G. D. Thurston, K. Ito, “Epidemiological Studies of Ozone Exposure Effects,” In: S. T. Holgate, J. M. Samet, H. S. Koren, R. L. Maynard, Air Pollution and Health, Academic Press, New York, 1999, pp. 485-510. doi:10.1016/B978-012352335-8/50097-1
[40] C. Restrepo, R. Zimmerman, G. Thurston, J. Clemente, J. Gorczynski, M. Zhong, M. Blaustein, L.C. Chen, “A comparison of ground-level air quality data with New York State Department of Environmental Conservation monitoring stations data in South Bronx, New York,” Atmospheric Environment, Vol. 38, Issue 31, 2004, pp. 5295-5304. doi:10.1016/j.atmosenv.2004.06.004
[41] A. Spira-Cohen, L. C. Chen, M. A. Kendall, R. Sheesley, G. D. Thurston, “Personal exposures to traffic-related particle pollution among children with asthma in the South Bronx, NY,” Journal of Exposure Science and Environmental Epidemiology, Vol. 20, No. 5, 2010, pp 446-456.
[42] H. R. Anderson, A. Ponce de Leon, J. M. Bland, J. S. Bower, J. Emberlin, D. P. Strachen, “Air pollution, pollens, and daily admissions for asthma in London 1987-92,” Thorax, Vol. 53, 1998, pp. 842-848. doi:10.1136/thx.53.10.842
[43] J. T. Lee, H. Kim, H. Song, Y. C. Hong, Y. S. Cho, S. Y. Shin, Y. J. Hyun, Y. S. Kim, “Air pollution and asthma among children in Seoul, Korea,” Epidemiology, Vol. 13, No. 4, 2002, pp. 481-484. doi:10.1097/00001648-200207000-00018
[44] J. Sunyer, C. Spix, P. Quénel, A. Ponce-de-León, A. P?nka, T. Barumandzadeh, G. Touloumi, L. Bacharova, B. Wojtyniak, J. Vonk, L. Bisanti, J. Schwartz, K. Katsouyanni, “Urban air pollution and emergency admissions for asthma in four European cities: the APHEA project,” Thorax, Vol. 52, 1997, pp. 760-765. doi:10.1136/thx.52.9.760
[45] National Archives and Records Administration. “Primary National Ambient Air Quality Standards for Nitrogen Dioxide. Federal Register,” Vol. 75, No. 26, Tuesday, February 9, 2010, pp. 6474-6537.
[46] G. D. Leikauf, S. Kline, R. E. Albert, C. S. Baxter, D. I. Bernstein, J. Bernstein, C. R. Buncher, “Evaluation of a Possible Association of Urban Air Toxics and Asthma,” Environmental Health Perspectives, Vol. 103, Suppl. 6, 1995, pp. 253-271. doi:10.1289/ehp.95103s6253

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