Journal
ENVIRONMENTAL HEALTH PERSPECTIVES
Volume 115, Issue 8, Pages 1140-1146Publisher
US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
DOI: 10.1289/ehp.9863
Keywords
childhood asthma; exposure to violence (ETV); geographic information systems (GIS); intraurban variability; nitrogen dioxide (NO2); social-environmental synergy; stress
Funding
- NHLBI NIH HHS [K08 HL04187] Funding Source: Medline
- NICHD NIH HHS [F31 HD049317-01A1, F31 HD049317] Funding Source: Medline
- NIEHS NIH HHS [T32 ES007142, R03 ES013988] Funding Source: Medline
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BACKGROUND: Disproportionate-life stress and consequent physiologic alteration (i.e., immune dysregulation) has been proposed as a major pathway linking socioeconomic position, environmental exposures, and health disparities. Asthma, for example, disproportionately affects lower-income urban communities, where air pollution and social stressors may be elevated. OBJECTIVES: We aimed to examine the role of exposure to violence (ETV), as a chronic stressor, in altering susceptibility to traffic-related air pollution in asthma etiology. METHODS: We developed geographic information systems (GIS)-based models to retrospectively estimate residential exposures to traffic-related pollution for 413 children in a community-based pregnancy cohort, recruited in East Boston, Massachusetts, between 1987 and 1993, using monthly nitrogen dioxide measurements for 13 sites over 18 years. We merged pollution estimates with questionnaire data on lifetime ETV and examined the effects of both on childhood asthma etiology. RESULTS: Correcting for potential confounders, we found an elevated risk of asthma with a 1-SD (4.3 ppb) increase in NO2 exposure solely among children with above-median ETV [odds ratio (OR) = 1.63; 95% confidence interval (0), 1.14-2-33)]. Among children always living in the same community, with lesser exposure measurement error, this association was magnified (OR = 2.40; 95% Cl, 1.48-3.88). Of multiple exposure periods, year-of-diagnosis NO2 was most predictive of asthma, outcomes. CONCLUSIONS: We found an association between traffic-related air pollution and asthma solely among urban children exposed to violence. Future studies should consider socially patterned susceptibility, common spatial distributions of social and physical environmental factors, and potential synergies among these. Prospective assessment of physical and social exposures may help determine causal pathways and critical exposure periods.
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