Background: Asthma is a growing epidemic in the U.S. Obesity, and more recently metabolic syndrome, has been shown to be associated with increased prevalence of asthma morbidity prevalence. Air pollution exposure, meanwhile, is associated with increased risk of acute asthma exacerbation. However, it is unclear the extent to which co-morbidities, specifically obesity and metabolic syndrome, increase the risk of air pollution related asthma morbidity. Methods: Data for 105,914 unscheduled asthma hospital admissions with a primary diagnosis of asthma in New York City (NYC) during 2003–2006, were obtained from the New York State Department of Health Statewide Planning and Research Cooperative Survey. Daily monitored pollutant concentrations from NYC-area monitors were averaged to determine daily exposure estimates for pollutants, including fine particulate matter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3). A Poisson, generalized linear model was utilized to assess the association of these acute air pollution exposures with daily asthma hospital admissions among children (ages 1–17), adults (ages 18–64), and older adults (ages 65 and older). Analyses stratified by secondary diagnoses were then performed to determine whether obesity or metabolic syndrome co-morbid conditions modified the associations of air pollution and asthma hospital admissions in these age subpopulations. Results: Asthma hospital admissions among children, adults, and older adults were significantly associated with acute air pollutant exposures. Children with obesity had significantly higher risk ratios for asthma hospital admissions vs. children without obesity for associations with PM2.5 and NO2, especially among girls with obesity and during the warm season of the year. While the individual co-morbidities corresponding to metabolic syndrome (i.e., hypertension, diabetes, obesity, and hyperlipidemia) were not observed to significantly modify the associations of air pollutants and asthma hospital admissions, adults and older adults with multiple secondary diagnoses corresponding to metabolic syndrome had significantly higher risk ratios for asthma hospital admissions vs. those without metabolic syndrome. Conclusions: Obesity in children, and metabolic syndrome in adults, significantly increased the risk of air pollution related asthma hospital admissions in NYC. This information may enhance the consideration of susceptibility to air pollution in government policymaking, as well as inform physicians advising at-risk patients.
|Advisor:||Thurston, George D., Gordon, Terry|
|Commitee:||Ito, Kaz, Nadas, Arthur, Silverman, Rob|
|School:||New York University|
|Department:||Environmental Health Science|
|School Location:||United States -- New York|
|Source:||DAI-B 73/07(E), Dissertation Abstracts International|
|Subjects:||Environmental Health, Epidemiology|
|Keywords:||Air pollution, Asthma, Asthma hospital admissions, Hospital, Metabolic syndrome, New York City, Obesity, Time-series|
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