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Air Pollution-Associated Changes in Lung Function among Asthmatic Children in Detroit
Toby C. Lewis,1 Thomas G. Robins,2 J. Timothy Dvonch,2 Gerald J. Keeler,2 Fuyuen Y. Yip,2 Graciela B. Mentz,3 Xihong Lin,4 Edith A. Parker,3 Barbara A. Israel,3 Linda Gonzalez,5 and Yolanda Hill6
Department of 1Pediatrics, 2Department of Environmental Health Sciences, 3Department of Health Behavior and Health Education, and 4Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA; 5Detroit Hispanic Development Coalition, Detroit, Michigan, USA; 6Department of Health and Wellness Promotion, Detroit, Michigan, USA
Abstract
In a longitudinal cohort study of primary-school-age children with asthma in Detroit, Michigan, we examined relationships between lung function and ambient levels of particulate matter ≤ 10 µm and ≤ 2.5 µm in diameter (PM10 and PM2.5) and ozone at varying lag intervals using generalized estimating equations. Models considered effect modification by maintenance corticosteroid (CS) use and by the presence of an upper respiratory infection (URI) as recorded in a daily diary among 86 children who participated in six 2-week seasonal assessments from winter 2001 through spring 2002. Participants were predominantly African American from families with low income, and > 75% were categorized as having persistent asthma. In both single-pollutant and two-pollutant models, many regressions demonstrated associations between higher exposure to ambient pollutants and poorer lung function (increased diurnal variability and decreased lowest daily values for forced expiratory volume in 1 sec) among children using CSs but not among those not using CSs, and among children reporting URI symptoms but not among those who did not report URIs. Our findings suggest that levels of air pollutants in Detroit, which are above the current National Ambient Air Quality Standards, adversely affect lung function of susceptible asthmatic children. Key words: air pollution, asthma, child, community-based participatory research, Detroit, lung function, ozone, particulate matter. Environ Health Perspect 113:1068-1075 (2005) . doi:10.1289/ehp.7533 available via
http://dx.doi.org/ [Online 6 May 2005]
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Address correspondence to T.C. Lewis, University of Michigan Pediatric Pulmonology, L2221 Women's Hospital, Box 0212, 1500 East Medical Center Dr., Ann Arbor, MI 48109-0212 USA. Telephone: (734) 764-4123. Fax: (734) 936-7635. E-mail:
TOBYL@umich.edu
We acknowledge the contribution of all the partners who have been involved in the Community Action against Asthma (CAAA) collaborative effort: University of Michigan Schools of Public Health and Medicine, the Detroit Department of Health and Wellness Promotion, the Michigan Department of Agriculture, Plant and Pest Management Division, the Henry Ford Health System, and nine community-based organizations in Detroit: Butzel Family Center, Community Health and Social Services Center, Detroiters Working for Environmental Justice, Detroit Hispanic Development Corporation, Friends of Parkside, Kettering/Butzel Health Initiative, Latino Family Services, United Community Housing Coalition, Warren/Conner Development Coalition. We also thank J. Barres for his efforts in field data collection and laboratory analysis and S. Andersen for her assistance in preparation of the manuscript.
This work was funded by the National Institute of Environmental Health Sciences (grants P01-ES09589-01, R01 ES010688, and K23 ES013242) and the U.S. Environmental Protection Agency (grant R826710-01) .
The CAAA is affiliated with the Detroit Community-Academic Urban Research Center (see
www.sph.umich.edu/urc for more information) .
The authors declare they have no competing financial interests.
Received 31 August 2004 ; accepted 5 May 2005.
Correction
The "Demographic and Asthma Characteristics of Cohort" section of "Results" in the manuscript originally published online was incorrect in describing less than two-thirds and 15% of the cohort ; it has been corrected here to fewer than one-half and 30%.
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