Global goods movement and the local burden of childhood asthma in southern California

Abstract

Objectives: As part of a community-based participatory research effort, we estimated the preventable burden of childhood asthma associated with air pollution in the southern California communities of Long Beach and Riverside.

Methods: We calculated attributable fractions for 2 air pollution reduction scenarios to include assessment of the newly recognized health effects associated with residential proximity to major roads and impact from ship emissions.

Results: Approximately 1600 (9%) of all childhood asthma cases in Long Beach and 690 (6%) in Riverside were attributed to traffic proximity. Ship emissions accounted for 1400 (21%) bronchitis episodes and, in more modest proportions, health care visits for asthma. Considerably greater reductions in asthma morbidity could be obtained by reducing nitrogen dioxide and ozone concentrations to levels found in clean coastal communities.

Conclusions: Both Long Beach and Riverside have heavy automobile traffic corridors as well as truck traffic and regional pollution originating in the Los Angeles-Long Beach port complex, the largest in the United States. Community-based quantitative risk analyses can improve our understanding of health problems and help promote public health in transportation planning.

FIGURE 1

Sensitivity analysis examining uncertainty of results for number of cases of asthma exacerbation attributable to ozone (O₃) and for number of cases of asthma attributable to traffic proximity in Riverside, CA. Note. Uncertainty is expressed as the percentage change from estimates. ^aReferences for alternative concentration response function are Delfino et al. for bronchitis episodes, Tolbert et al. for emergency department visits, and Sheppard et al. for hospital admissions. ^bDifference in air pollution–attributable asthma cases with a reduction scenario assuming that 5% of the population will remain living within 75 m of busy road instead of 0% as in the core estimates.