Original Articles: Mechanisms of Allergic and Immune DiseasesTraffic and outdoor air pollution levels near residences and poorly controlled asthma in adults
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INTRODUCTION
Despite major advances in the development of anti-inflammatory medications in the last 2 decades, many Americans have poorly controlled asthma. In California, nearly 25% of adults diagnosed as having asthma experienced asthma symptoms every day or week, 7.2% of adults reported at least 1 emergency department (ED) visit for asthma, and 2.2% reported they were hospitalized for asthma in 2000.1 Poorly controlled asthma, either chronic or acute, contributes disproportionately to the overall costs
Study Population
This study linked population-based survey data obtained from respondents of CHIS 2001 with traffic count and ambient air monitoring data. Eligible respondents were individuals from whom health data were collected between November 2000 and September 2001 as part of CHIS 2001. The University of California, Los Angeles, Institutional Review Board approved this study as exempt from review. A total of 55,428 California households were surveyed in English, Spanish, Chinese, Vietnamese, Korean, or
RESULTS
The study population was composed of more women (58.1%) and nonelderly adults (Table 1). Among nonelderly adults with asthma, 18.6% were current smokers. The overall prevalence of poorly controlled asthma was 26.3% for all asthmatic adults 18 years and older. The prevalence of poorly controlled asthma increased with age and reached 38.1% among elderly adults (≥65 years). Women reported a slightly higher prevalence of poorly controlled asthma than men (27.9% vs 24.1%). Adults with a family
DISCUSSION
Our results add to the growing body of epidemiologic evidence that suggests that adults with asthma are adversely affected by long-term exposure to air pollution. Because of the lack of an asthma disease registry in the United States, population-based data such as those from the CHIS are valuable not only for understanding the prevalence of poorly controlled asthma in various regions or subpopulations, but also for performing association studies such as the one presented herein through linking
ACKNOWLEDGMENTS
The authors thank Yan Xiong, MS, and others for statistical and programming support and Sheila Nathan, MPH, and Marlena Kuruvilla, MSW/MPH, for research assistance.
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This study was supported by the Agency for Toxic Substances and Disease Registry (ATSDR: U61/ATU972304). Its contents do not necessarily represent the official views of ATSDR.