Presenting Author: Jane E. Clougherty, MSc, ScD, Drexel University Dornsife School of Public Health

ABSTRACT

Growing evidence suggests that chronic social stressors (e.g., poverty, violence exposures) may modify associations between chronic air pollution exposures and health. Relatively few studies, however, have examined whether the effects of acute air pollution exposures vary by social or socioeconomic stressors, or how these spatial modifiers influence the apparent effects of spatio-temporal pollution exposure estimates.

In this study, we estimate residence- and day-specific ozone exposure estimates for multiple lag days, by combining highly spatially-resolved intra-urban concentration surfaces with regulatory monitoring data. Applying conditional logistic regression (Cox Proportional Hazard) models in a case-crossover design, adjusting for temperature and co-pollutant exposures, we examined associations with asthma exacerbations. Outcome data was limited to citywide hospital records for children aged 5 to 17 years, during the warm season (June - August) asthma hospitalizations (n = 2,353) and Emergency Department (ED) visits (n = 11,719), from 2005-2011.

In keeping with our prior studies, we found elevated associations between ozone and exacerbation risk for lag days 1 through 3. Risks associated with ozone exposure were consistently lowest in communities with the lowest violent crime rates, and increased with increasing community violence. Similarly, we found that ozone conferred lesser risk in communities with lesser socioeconomic deprivation, and that risks increased in a roughly dose-response manner.

Subsequent analyses will develop cross-stratified models, using both modifiers, to compare and contrast modification attributable to each stressor.

Authors: Jane E. Clougherty, MSc, ScD; Jessie Shmool, MS, PhD; Ellen Kinnee; and Perry Sheffield, MD, MPH.