COMPARING ASTHMA IN
NEW YORK TO ASTHMA IN OTHER CITIES
By Imrana Ahmed
The 5 Asthma "Hot Spots"
Studies Done Relating Air Quality and Asthma
Hypothesis derived from previous Studies
The Main Air Pollutants Affecting Asthma
Observations Made From the Available Data
Conclusion
Discussion of Other Asthma Factors
How does New York Differ from the Other Asthma
"Hot Spots?"
List of Sources
THE 5 ASTHMA HOT SPOTS
New York is one of the hot spots for asthma. The current list of the actual
hot spots in the US is as follows:
1
Tucson
2
Kansas City
3
Phoenix, Arizona
4
Fresno, California
5
New York
These five cities
are major contributors of the nationwide 5,000 annual death caused by asthma.
Studies Done Relating Air Quality and Asthma
There are many previous research studies that connect asthma and air pollutants.Air
pollution have been associated with reductions in lung function, aggravation
of asthma, increased risk of pneumonia in the elderly, increased hospital
admissions, and even deaths (Bates, 1999, Anderson, 1999).
In addition, long term exposure to particulate matter has been associated
with an increase in lung cancer and cardiopulmonary mortality (Pope, et
al., 2002).
In other clinical studies, ozone, nitrogen dioxide, sulfur dioxide, and
particulate matter have been shown to worsen asthma attacks, by increasing
inflammation.Looking at data from 1970-1998, the death rate from asthma increased
55.6% even though the death rates from all causes combined decreased 18%;
overall, the prevalence asthma in the US has been increasing (CDC, 2001).
Studies have been done showing a correlation between outdoor air quality
and the risk for developing asthma. For example, one study estimated that
the relative risk of active children developing asthma in communities with
high ozone as 3.3 (McConnell, et al. 2002).
However, there are, many other factors ranging from pollen to indoor pollution
that play a role in asthma attacks. Another study found that there was a
35% increase in the daily hospitalization rate of children under two years
of age was related to an increase in the ozone concentration (Burnett, et
al., 20001).
Another study explored the relationship between hospital asthma admissions
and air pollution in New York City; they found that pollution had a stronger
connection with hospital visits during the spring and summer and certain
air mass types, while in the fall and winter, air mass had more of an effect
(Jamason, et al. 1997).
Therefore, research of the effects of air quality on mortality, hospital
and ER visits, absenteeism, and lung function have proven that there is
an important correlation between air quality and our health.
For example, a study done by the California ChildrenÕs Health Studies
showed that diminished lung function was associated with living in communities
with higher concentrations of pollutants (Peters, et al. 1999).As the children
were moved from areas with high levels of PM10 to low levels of PM10 there
lung function had increased, as a result. However, there is still a need
for more research and more hard data in order to define the asthma/air quality
relationship.
http://airmapnew.unh.edu/assessment/PDF/Adam_Proposal.pdf
Hypothesis derived from previous Studies
Based on the studies discussed above and personal experience it seems that there must be a connection between air pollution and asthma. For example, asthma patients who immigrate from developing nations to wealthy nations such as the United States, have shown to have decreased their asthma attacks, tremendously.
The air pollutant level of Tuscon should be higher than the other 4 cities
mentioned because Tuscon is the number one asthma Òhot spotÓ
within the United States.
The Main Air Pollutants Affecting Asthma
As mentioned above, these five cities are major contributors of the nationwide
5,000 annual death caused by asthma. (
www.freebreather.com/iSyndicate/isyn.managed-news
)Comparing the data
for these five cities show how there are different factors and pollutants
in each of the cities lead to many asthma hospitalizations.
For example, the PSI
(Pollutant Standard Index) charts provided by the Environmental Protection
Agency (EPA) showed
that main pollutant in each city differed.
|
Name of City |
Type of the highest pollutants in the city |
|
Tucson, Arizona |
Ozone (O3), PM10 |
|
Kansas City |
Ozone |
|
Phoenix, Arizona |
Ozone, Carbon monoxide, & PM10 |
|
Fresno, California |
PM10 |
|
New York |
Ozone |
Main Pollutants Involved
(http///www.epa.gov)
A daily index value is calculated for each criteria air pollutant concentration
measured at air monitoring sites in a county. The highest of those index
values is a county's PSI value, and the pollutant responsible for the highest
index value is the "Main Pollutant." The criteria pollutants used to calculate
PSI are:
á
CO - Carbon monoxide
á
NO
2
- Nitrogen dioxide
á
O
3
- Ozone (1-hour average)
á
SO
2
- Sulfur dioxide
á
PM
10
- Particulate matter with diameter <10 micrometer
|
Pollutant |
Main Human Activity Sources |
Health Effect |
|
Ozone |
Produced by the photochemical action on nitrogen oxides (NOx)and volatile
organic compounds (VOCs). 1/3 of VOCs come from the burning of fossil
fuels for transportation |
Irritation of
the lungs and difficulty breathing. Exposure to high concentrations can
result in chest tightness, coughing and wheezing |
|
Carbon Monoxide |
Emission from
the transportation sector and other fuel combustion processes
|
Restricts oxygen flow to the vital organs, impairing function |
|
Nitrogen Dioxide |
Automobiles, thermal
power plants, incinerators |
Causes increased sensitivity for people with asthma |
|
Particulate Matter (PM10) |
Combustion, incineration,
construction, motor vehicle exhaust, road dust |
Irritation of
the lungs and difficulty breathing. |
|
Sulfur Dioxide |
Electric utilities,
smelters, pulp and paper industry and petroleum refineries |
Breathing discomfort,
respiratory illness |
Government of Ontario. 1998. Air Quality in Ontario 1996. Ministry of the
Environment.
http://www.cleanairchampions.ca/theissues.asp?title=theissue
National Ambient Air Quality Standards
POLLUTANT STANDARD VALUE *
STANDARDTYPE
------------------------------------------------------------------------
Carbon Monoxide (CO)
8-hour Average
9 ppm
(10 mg/m3
) Primary
1-hour Average
35 ppm
(40 mg/m3
) Primary
Nitrogen Dioxide (NO2
)
Annual Arithmetic Mean
0.053 ppm
(100 µg/m
3)
Primary & Secondary
Ozone (O3
)
1-hour Average
0.12 ppm (235
µg/m 3
)
Primary & Secondary
8-hour Average
0.08 ppm (157
µg/m 3
)
Primary & Secondary
Lead (Pb)
Quarterly Average
1.5 µg/m3
Primary & Secondary
Particulate (PM 10) Particles with diameters of 10
micrometers or less
Annual Arithmetic Mean
50 µg/m
3
Primary & Secondary
24-hour Average
150 µg/m3
Primary & Secondary
Particulate (PM 2.5) Particles with diameters of 2.5
micrometers or less
Annual Arithmetic Mean
15 µg/m
3
Primary & Secondary
24-hour Average
65 µg/m3
Primary & Secondary
Sulfur Dioxide (SO2
)
Annual Arithmetic Mean
0.030 ppm
(80 µg/m
3)
Primary
24-hour Average
0.14 ppm
(365 µg/m3
)
Primary
3-hour Average
0.50 ppm (1300
µg/m 3
)Secondary
* Parenthetical value is an approximately equivalent concentration
http://www.epa.gov/airs/criteria.htnl
Observations Made From the Available Data
The graphs below were made using main pollutant levels for a period of 10 days within the year 2001. The first five graphs will look at the air pollutant level of each city separately and will keep in mind the different pollutants involved. Then in the last graph, we will compare and contrast the levels between these five cities.
From the above
graphs, it is clearly seen that New YorkÕs PSI values are lower than
from the four other cities mentioned, NY being the fifth asthma Òhot
spotsÓ However, we also see that Tuscon, the number 1 hot spot does
not have the have highest pollutant level.
The hypothesis, therefore, is disproved; air pollutant level
of Tuscon is lower compared to that of Phoenix, Arizona, which is the 3
rd asthma Òhot spots.Ó
The graphs above show that air pollution is not the only factor for the
increasing or decreasing rate of asthma within a city.
Discussion of Other Asthma Factors
However, it is not sufficient to look at each value of pollutant level
on its own and make conclusions. The data need to be looked at while keeping
all the other variables in mind. For example, there should be concerns about
the
genetics
of the population being most affected by pollutant. This plays an important
role because minorities tend to show a higher rate of asthma due to their
living conditions. Other data
have shown that the emissions of hazardous materials over a period of time
also play an important role. For example, TucsonÕs long pollen seasons
increased its asthma rates, especially in the case of children.
A cityÕs climate also plays a key role. Many Respiratory disorders,
especially asthma can also be aggravated
by higher temperatures. As a result, concentrations ozone, which is the
major component of smogalso tend to
rise. This exposure to high ozone levels will then
cause severe coughing, shortness of breath, pain when breathing,
etc. Higher ozone levels have been shown
to cause more asthma attacks; it increase
s the need for medications
and as a result in more hospital
admissions and visits to emergency rooms.
(
http://www.psr.org/heatexcerpt.html
)
How Does NY Differ From the Other ÒHot Spots?Ó
In New York, the major source of pollutants
is vehicle emissions. The fact that
many children in NY are affected by asthma indicates the cityÕs poor
air quality.As the writer of Gotham: The State of the City point out that
between 1982-1985, asthma death in New York had tripled compared to the
national average. Between 1986 and 1994, the rate of hospitalizations
for asthma had increased 18 percent, from 39.2 to 46.2 per 10,000 children
.
According to a recent
study hospitalization rates for asthma are as much as 21 times higher among
poor children. This is seen predominantly in minority neighborhoods some
of New York's busiest bus and truck routes run through or near these poor
communities.
Another issue is that New York City has a total of 3980 public and private
AVFs and 20 clean-fuel refueling stations. This is a very low number compared
to other cities such as Atlanta, which has many more AVFÕs but a
low population to that New York. However, in order to improve this situation,
New York has obtained on alternative fuel vehicles, such as hybrid buses
and was also able to receive federal and state funding for the current 125
hybrid buses.
(
http://www.informinc.org/alongroadcity.pdf
)
It seems that New York and the other big cities have finally started to
organize programs that cater to each cityÕs needs, whether it be by
monitoring poorer neighborhoods or by increasing asthma centers within these
neighborhoods, or by increasing the number of AFVÕs or through the
alternative fuel vehicles. The fact is that comparisons of asthma rates or
among cities will be made with better accuracy if each city will have the
equal and necessary resources for its people.
Even though it is difficult to prevent exposure to outdoor
air pollution, particularly (but not exclusively) in urban areas, there
are still ways to control it. The greatest step individuals can take is
to NOT drive their automobile and use active means of transportation (i.e.
walk, bike, run, roll) whenever it is safe and possible to do so.
We must also be aware of air quality advisories
and understand the health risks from being exposed to poor air quality. Parents
should strive to limit children's strenuous activity outdoors on poor air
quality days, especially if their child has pre-existing respiratory problems.
Athletes should avoid exercising outside on smog alert days if possible.
Their physical activity should be avoided particularly during the peak rush
hour times and they should avoid heavy traffic routes whenever possible.
http://www.cleanairchampions.ca/theissues.asp?title=theissues
T
herefore, Bike to work, Walk to school, skate board
to soccer practice, take public transit, leave the car behind and choose
to get active for the environment and for your health. You will feel better
and children will thank you!
Mallarkey, Gordon. ÒAsthma Management for the New Millenium.Ó
Adis Internationa: Hong Kong, 1999.
Plaut, Thomas F.ÒDr. Tom PlautÕs: Asthma Guide For People
of All Ages.ÓPredipress, Inc.: Amherst, Massachusetts, 1999.
Lane, Donald J.ÒAsthma: The Facts.ÓOxford University Press:
Oxford, England, 1996.
Burnett, R. et al.Association between ozone and hospitalization for acute
respiratory diseases in children less than 2 years of age.Am. J. Epidemiol.
153:5 444-452 (2001)
Jamason, P. et al.A synoptic Evaluation of Asthma hospital Admissions in
New York City. Am. J. Respir. Crit Care Med. 156: 1781-1788 (1997)
McConnell, R. et al. Assessment of human exposure to ambient particulate
matter.J. Air & waste Management Assoc. 49:1280-1291 (1999)
www.freebreather.com/iSyndicate/isyn.managed-news
www.informinc.org/alongroadcity.pdf
www.columbia.edu/cu/lweb/indiv/dsc/stats/ny.html
www.lungusa.org/press/association/asnhisp2.html
http://www.psr.org/heatexcerpt.html
http://www.cleanairchampions.ca/theissues.asp?title=theissues
http://airmapnew.unh.edu/assessment/PDF/Adam_Proposal.pdf