Changes in emergency department visits for respiratory and cardiovascular disease after closure of a coking operation near Pittsburgh, PA
Introduction: In Allegheny County (AC), PA, US, closure of a large coke plant in January 2016 presented an opportunity to investigate the contribution of air pollutants to health outcomes in a nearby community.
Materials and methods: The Allegheny County Health Department, (ACHD), Division of Air Quality, had begun monitoring pollutants near the plant since June 2011. The rates of hospitalizations and ED visits for cardiovascular and respiratory disease were compared in the exposed community and two control areas: exposed control, with another coking operation; and unexposed control.
Results: Of the study and two control areas, particulate matter concentrations decreased the most in the study area, from 10.9 µg/m3 to 9.7 µg/m3. Benzene decreased substantially in that area, from 0.27 ppm to 0.10 ppm. ED visits for cardiovascular, respiratory, and asthma were significantly higher in the exposed group in 2015 compared to 2016. There were no temporal differences in either control groups. There was a 26.5% decrease in cardiovascular ED visits, a 37.9% decrease in respiratory ED visits, and a 3-5 fold decrease in ED visits due to asthma. These decreases were not seen in exposed and unexposed control areas. A case-crossover analysis confirmed that daily ED visits were significantly associated with daily particulate matter levels, controlling for temperature.
Conclusion: With the closure of a large Coke Plant facility, we found that a modest decrease in particulate matter and a notable decrease in benzene concentration were associated with a significant decrease in emergency room visits not previously documented in other studies.
Retrieved from https://www.epa.gov/air-trends/particulate-matter-pm25-trends. July 3, 2018.
2. Brook R, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, et al. Expert Panel on Population and Prevention Science of the American Heart Association. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004; 109(21):2655–2671.
3. Makar M, Antonelli J, Di Q, Cutler D, Schwartz J, Dominici F. Estimating the Causal Effect of Fine Particulate Matter Levels on Death and Hospitalization: Are Levels Below the Safety Standards Harmful? Epidemiology (Cambridge, Mass). 2017;28(5):627.
4. Mazumdar S, Sussman N. Relationships of air pollution to health: results from the Pittsburgh study. Archives of Environmental Health: An International Journal. 1983;38(1):17-24.
5. Arena V, Mazumdar S, Zborowski J, Talbott EO, He S, Chuang Y-H, et al. A retrospective investigation of PM10 in ambient air and cardiopulmonary hospital admissions in Allegheny County, Pennsylvania: 1995-2000. Journal of Occupational and Environmental Medicine. 2006 Jan;48(1):38-47.PMID: 16404208
6. Wellenius GA, Bateson TF, Mittleman MA, Schwartz J. Particulate air pollution and the rate of hospitalization for congestive heart failure among medicare beneficiaries in Pittsburgh, Pennsylvania. American Journal of Epidemiology. 2005 Jun 1;161(11):1030-6. PMID: 15901623
7. Glad JA, Brink LL, Talbott EO, Lee PC, Xu X, Saul M, Rager J. The Relationship of Ambient Ozone and PM2.5 Levels and Asthma Emergency Department Visits: Possible Influence of Gender and Ethnicity. Archives of Environmental & Occupational Health. 2012Apr 1; 67(2): 103-108. PMID: 22524651
8. Dabass A, Talbott EO, Bilonick RA, Rager JR, Venkat A, Marsh GM, et al. Using spatio-temporal modeling for exposure assessment in an investigation of fine particulate air pollution and cardiovascular mortality. Environmental Research. 2016 Nov 1;151:564-572. doi: 10.1016/j.envres.2016.08.024. Epub 2016 Aug 31. PMID: 27591528
9. Pope III CA, Dockery DW. Health effects of fine particulate air pollution: lines that connect. Journal of the air & waste management association. 2006;56(6):709-42.
10. Pope 3rd CA. Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am J Public Health. 1989 May;79(5):623-8. PMID: 2495741
11. Pope 3rd CA. Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys . Archives of Environmental Health: An International Journal. 1991 Mar-Apr;46(2):90-7. PMID: 2006899.
12. Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA. 2001 Feb 21;285(7):897-905. PMID: 11180733.
13. Li Y, Wang W, Kan H, Xu X, Chen B. Air quality and outpatient visits for asthma in adults during the 2008 Summer Olympic Games in Beijing. Science of Total Environment. 2010 Feb 1;408(5):1226-7. doi: 10.1016/j.scitotenv.2009.11.035. Epub 2009 Dec 3. PMID: 19959207.
14. C-CAT. Apex Epidemiology, New York State Department of Health. 2006.
15. Fung KY, Krewski D, Chen Y, Burnett R, Cakmak S. Comparison of time series and case-crossover analyses of air pollution and hospital admission data. International Journal of Epidemiology. 2003 Dec;32(6):1064-70.
16. Lipfert FW: A critical review of studies of the association between demands for hospital services and air pollution. Environmental Health Perspectives. 1993, 101(Suppl 2):229–268.
17. Winquist A, Klein M, Tolbert P, Flanders WD, Hess J, Sarnat SE. Comparison of emergency department and hospital admissions data for air pollution time-series studies. Environmental Health. 2012;11(1):70.
18. Samet JM, Zeger SL, Dominici F, Curriero F, Coursac I, Dockery DW, et al. The National Morbidity, Mortality, and Air Pollution Study. Part II: Morbidity and mortality from air pollution in the United States. Res Rep Health Eff Inst. 2000 Jun;94(Pt 2):5-79.
19. Franklin M, Zeka A, Schwartz J. Association between PM2.5 and all-cause and specific-cause mortality in 27 US communities. Journal of Exposure Science and Environmental Epidemiology. 2007 May;17(3):279-87. Epub 2006 Sep 27. PMID: 17006435.
20. Stenlund T, Lidén E, Andersson K, Garvill J, Nordin S. Annoyance and health symptoms and their influencing factors: a population-based air pollution intervention study. Public Health. 2009 Apr;123(4):339-45.
21. Shmool JL, Kubzansky LD, Newman OD, Spengler J, Shepard P, Clougherty JE. Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures. Environ Health. 2014 Nov 6;13(1):91.
22. Clougherty JE, Levy JI, Kubzansky LD, Ryan PB, Suglia SF, Canner MJ, et al. Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environmental Health Perspectives. 2007;115:1140–1146.
23. Clougherty JE, Rossi CA, Lawrence J, Long MS, Diaz EA, Lim RH, et al. Chronic social stress and susceptibility to concentrated ambient fine particles in rats. Environmental Health Perspectives. 2010;118(6):769–775
24. Wyzga RE, Rohr AC. Long-term particulate matter exposure: Attributing health effects to individual PM components, Journal of the Air & Waste Management Association, 2015, 65(5):523-543.
|Issue||Vol 4 No 4 (2019): Autumn 2019|
|Natural experiment; Epidemiology; Particulate matter|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|