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2006 Progress Report: Impact of Exposure to Urban Air Toxics on Asthma Utilization for the Pediatric Medicaid Population in Dearborn, Michigan

EPA Grant Number: R828678C012
Subproject: this is subproject number 012 , established and managed by the Center Director under grant R824834
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
Center: Mickey Leland National Urban Air Toxics Research Center (NUATRC)
Center Director: Beskid, Craig
Title: Impact of Exposure to Urban Air Toxics on Asthma Utilization for the Pediatric Medicaid Population in Dearborn, Michigan
Investigators: Wahl, Robert L
Institution: Division of Environmental and Occupational Epidemiology
EPA Project Officer: Katz, Stacey
Project Period: January 2, 2001 through December 31, 2005 (Extended to December 31, 2008)
Project Period Covered by this Report: January 2, 2005 through December 31, 2006
RFA: Targeted Research Center (2004)
Research Category: Hazardous Waste/Remediation , Targeted Research

Description:

Objective:

The overall objective of this proposal is to assess the relationship between exposures to ambient levels of certain urban air toxics (UATs), as measured by outdoor air monitors, and utilization of urgent care facilities by children enrolled in Medicaid in Dearborn, Michigan. The two principal hypotheses and related aims follow:

Hypothesis 1: Levels of selected UATs, including 1,3-butadiene, acetaldehyde, acetonitrile, benzene, carbon tetrachloride, chloroform, formaldehyde, methylene chloride, tetrachloroethene, and trichloroethene, are related to measures of urgent care utilization for asthma among a pediatric Medicaid population in Dearborn, MI.

The specific aims are:
Develop a set of exposure measures based on daily measurement data of the selected UATs available at the Dearborn monitor between April 19, 2001, and April 19, 2002, along with other pollutants known or likely to be associated with asthma (O3, PM, etc.).

  1. Obtain Medicaid files on children from 1 –17 years of age residing in Dearborn between April 19, 2001, and April 19, 2002, on daily utilizations of urgent care facilities, including hospital visits and urgent care visits.
  2. Link the exposure measures and Medicaid files.
  3. Analyze the relationships between daily fluctuations in concentrations of the UATs and daily urgent care utilization for asthma using appropriate statistical models.

Hypothesis 2: UAT concentrations represent contributions from various emission source groupings that in turn are related to urgent care utilization for asthma among the same pediatric Medicaid population.

The specific aims for this hypothesis are:

  1. Develop daily source apportionment scores for the selected Dearborn UATs using multivariate models and ambient air quality data.
  2. Analyze the relationship between source category scores and urgent care utilizations for asthma using appropriate statistical models.
  3. Assess the variability in the apportionment scores using alternative method to derive the source scores.

Project Background:

This is an ongoing 2-year study under the NUATRC Small Grants Program. A Research Contract was signed between NUATRC and Michigan Department of Community Medicine on 29 December 2004-2006. The Investigators are collaborating with the University of Michigan on this project.

Progress Summary:

During this periods the Investigators Perform descriptive analysis of the UAT data. The final toxics data set includes 23 toxics (carbonyls and VOCs). In addition, they assembled PM10 and PM2.5 at the (same) Dearborn monitoring station, as well as other criteria pollutants (O3, NO2, SO2, CO, PM2.5) and meteorological variables (temperature, relative humidity, pressure, wind speed and direction, and mixing height) monitored at nearby monitoring sites. They also performed descriptive analysis of the MEDICAID data. Daily counts of hospital admissions, emergency department / urgent care visits, and office visits for each diagnosis category were summarized for the study year (April 19, 2001 – April 18, 2002) and the following year (April 19, 2002 – April 18, 2003) for comparison purposes. In total, 43,800 outcomes (asthma, respiratory, or injury) were counted for the study year, with a mean daily count of 120 events (minimum: 17; maximum: 361). In comparison, the following year had 39,420 total events with a mean daily count of 108 events (minimum: 17, maximum: 290).

The Investigators have begun to develop a protocol to link the UAT files with the MEDICAID files, protocol to statistically analyze the relationship between exposure to UAT and urgent care utilization for asthma exacerbations. They have developed a protocol to link the UAT files with the MEDICAID files and performed a number of analyses utilizing the Medicaid data as an outcome with a variety of explanatory variables including criteria and air toxics pollutants using a Poisson regression modeling framework. These models are undergoing a variety of diagnostic and validation steps, and will be refined to handle issues including lags and seasonal variation. They have developed protocol to statistically analyze the relationship between exposure to UAT and urgent care utilization for asthma exacerbations and begun analysis.

A 2nd year 5-month Progress Report received on Oct 16, 2006 was reviewed by the SAP; the investigators have made good progress on data importation. The investigators have also begun modeling health outcomes using the observed exposure data. It is evident that they are beginning the modeling phase of the project. However, much work still needs to be done and the Investigators may be behind schedule. The research has been extended for an additional six months at the request of the PI’s and it will now end in June 2007.

Future Activities:

The next report will be an interim final report annual report due in March 2007.

Supplemental Keywords:

 , Ecosystem Protection/Environmental Exposure & Risk, HUMAN HEALTH, Scientific Discipline, Health, RFA, PHYSICAL ASPECTS, Health Effects, Risk Assessments, Aquatic Ecosystems & Estuarine Research, Health Risk Assessment, Physical Processes, Aquatic Ecosystem, Biochemistry, Genetics, water quality, urban environment, airborne urban contaminants, environmental tobacco smoke, respiratory disease, ozone, human health risk, air pollution, airway disease, particulate matter, exposure, allergic airway disease, asthma, human exposure

Progress and Final Reports:
2005 Progress Report
Original Abstract
2007 Progress Report


Main Center Abstract and Reports:
R824834    Mickey Leland National Urban Air Toxics Research Center (NUATRC)

Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R824834C001 Air Toxics Exposures Among Teenagers in New York City and Los Angeles - A Columbia-Harvard Study (TEACH)
R824834C002 Cardiopulmonary Response to Particulate Exposure
R824834C003 VOC Exposure in an Industry Impacted Community
R824834C004 A Study of Personal Exposure to Air Toxics Among a Subset of the Residential U.S. Population (VOC Project)
R824834C005 Methods Development Project for a Study of Personal Exposures to Toxic Air Pollutants
R824834C006 Relationship Between Indoor, Outdoor and Personal Air (RIOPA)
R824834C007 Development of the "Leland Legacy" Air Sampling Pump
R824834C008 Source Apportionment of Indoor Polycyclic Aromatic Hydrocarbons (PAHs) in Urban Residences
R824834C009 Development of a Personal Cascade Impactor Sampler (PCIS)
R824834C010 Testing the Metals Hypothesis in Spokane
R828678C001 Air Toxics Exposures Among Teenagers in New York City and Los Angeles—A Columbia-Harvard Study (TEACH)
R828678C002 Cardiopulmonary Effects of Metal-Containing Particulate Exposure
R828678C003 VOC Exposure in an Industry Impacted Community
R828678C004 A Study of Personal Exposure to Air Toxics Among a Subset of the Residential U.S. Population (VOC Project)
R828678C005 Oxygenated Urban Air Toxics and Asthma Variability in Middle School Children: A Panel Study (ATAC–Air Toxics and Asthma in Children)
R828678C006 Relationship between Indoor, Outdoor and Personal Air (RIOPA). Part II: Analyses of Concentrations of Particulate Matter Species
R828678C007 Development of the “Leland Legacy” Air Sampling Pump
R828678C008 Source Apportionment of Indoor PAHs in Urban Residences 98-03B
R828678C009 Development of a Personal Cascade Impactor Sampler (PCIS)
R828678C010 Testing the Metals Hypothesis in Spokane
R828678C011 A Pilot Geospatial Analysis of Exposure to Air Pollutants (with Special Attention to Air Toxics) and Hospital Admissions in Harris County, Texas
R828678C012 Impact of Exposure to Urban Air Toxics on Asthma Utilization for the Pediatric Medicaid Population in Dearborn, Michigan
R828678C013 Field Validation of the Sioutas Sampler and Leland Legacy Pump – Joint Project with EPA’s Environmental Technology Validation Program (ETV)
R828678C014 Performance Evaluation of the 3M Charcoal Vapor Monitor for Monitor Low Ambient Concentrations of VOCs
R828678C015 RIOPA Database Development
R828678C016 Contributions of Outdoor PM Sources to Indoor and Personal Exposures: Analysis of PM Species Concentrations” Focused on the PM Speciation and Apportioning of Sources
R828678C017 The Short and Long-Term Respiratory Effects of Exposure to PAHs from Traffic in a Cohort of Asthmatic Children

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The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.

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