The association between air pollution and childhood asthma: United States, 2010–2015

Abstract

Objective

The current population-based study examines the association between county-level ambient air pollution and childhood asthma.

Methods

Data from the nationally representative 2010–2015 National Health Interview Survey were linked to nationwide fine particulate matter (PM_2.5) air pollution data at the county-level from the National Environmental Public Health Tracking Network which utilizes air quality monitoring stations and modeled PM_2.5 measurements (Downscaler model data) and adjusted by county-level socioeconomic characteristics data from the 2010–2015 American Community Survey. Multilevel modeling techniques were used to assess the association between PM_2.5 annual concentrations (quartiles < 8.11, 8.11–9.50, 9.51–10.59, ≥ 10.60 µg/m³) and current childhood asthma along with two asthma outcomes (episode in the past year, emergency room (ER) visit due to asthma).

Results

From 2010 to 2015, there were significant declines in PM_2.5 concentrations and asthma outcomes. In unadjusted models, children living in areas with higher PM_2.5 concentrations were more likely to have current asthma, ≥1 asthma episode in the past year, and ≥1 ER visit due to asthma compared with children living in areas with the lowest quartile (< 8.11 µg/m³). After adjusting for characteristics at the county, geographic, and child and family-level, significant associations remained for asthma episode, and ER visit among children living in areas with PM_2.5 annual concentrations between 9.51 and 10.59 µg/m³ (3rd quartile) compared with children living in areas with the lowest quartile.

Conclusions

This study adds to the limited literature by incorporating nationally representative county-, child-, and family-level data to provide a multi-level analysis of the associations between air pollution and childhood asthma in the U.S.

Acknowledgments

The authors would like to thank James Dahlhamer, Ambarish Vaidyanathan, Nataliya Kravets, and Jennifer Parker for their help in this research study.

Conflicts of interest

The authors have no financial relationships relevant to this article to disclose.

Funding

The authors have no conflicts of interest to disclose.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

The author(s) reported there is no funding associated with the work featured in this article.