An air pollution study by a California State University, Fresno institute indicates that as ozone and fine particulates in central San Joaquin Valley air increase, so do rates of children’s asthma emergency-room visits and hospitalizations.
The study by the Central Valley Health Policy Institute at Fresno State provides new regional evidence for the public health consequences of air pollution.
It offers the first local evidence of short-term population-level health effects associated with elevations in fine particulates and ozone for the Valley. Data are presented on air pollution impacts on emergency room and hospital use for respiratory and cardio-vascular conditions in the region’s most populous urban centers: Fresno/Clovis, Bakersfield and Modesto.
An estimated 1,830 additional asthma emergency room visits per year for children were associated with ozone and fine particulate matter (PM 2.5). Children also experienced increased use of hospital emergency rooms for pneumonia, and adults were more likely to be hospitalized for asthma and acute myocardial infractions as levels of PM 2.5 increased.
The study, “The Impacts of Short-Term Changes in Air Quality on Emergency Room and Hospital Use in California’s San Joaquin Valley,” was conducted by the Fresno State institute for the San Joaquin Valley Air Pollution Control District. Funding was made possible by the District and the California Wellness Foundation.
Institute Director John Capitman said, “The San Joaquin Valley is arguably the most polluted air basin in the United States. In particular, Bakersfield and Fresno are consistently ranked by the American Lung Association as the No. 1 and No. 2 cities in the nation, respectively, for the highest concentrations of short-term ambient fine particulate matter (PM2.5).
“This study combined air quality and health care utilization data for Fresno/Clovis, Bakersfield and Modesto to address the question: Are short-term increases in air pollution (PM2.5 or ozone) associated with respiratory and cardiovascular emergency department and hospital admissions in the San Joaquin Valley?” Capitman said.
Tim Tyner, associate director of the Center for Clinical and Translational Research, UCSF-Fresno and co-author of the report, noted, “We found that children in particular face increasing risks for asthma exacerbations severe enough to seek care in the ER with increasing PM 2.5. Regionally, kids with asthma are more likely to end up in the ER even when air quality is rated as moderate [Yellow AQI], with the risk increasing linearly as air pollution worsens [i.e. Orange and Red AQI].
“The linear trend in the relationship between increasing air pollution and increasing asthma ER visits, after controlling for weather and other pollutants, and the similar outcomes observed at the individual city level, increase our confidence in these findings,” Tyner said.
David Lighthall, health science adviser for the San Joaquin Valley Air Pollution Control District, emphasized that the study results validate past efforts by the district and CARB to place further limits on sources of PM2.5 and ozone.
“For example, we now know that the significant reduction in wintertime air pollution that has resulted from wood burning restrictions is having a proportional health benefit for Valley residents, especially asthmatics. The same can be said for CARB’s motor vehicle controls,” Lighthall said.
“Our Valley air quality is a trigger for many asthmatics”, said Patti Burton, certified asthma educator and case manager with the Asthma Education and Management Program at Community Regional Medical Center.
“On a ‘bad air day’ (air quality is moderate or worse) the asthmatic should minimize outdoor activity, or even cancel it and stay indoors; be sure to use their medication at any signs of early distress; and seek medical attention in case of emergency,” Burton said.
The findings may also inform ongoing air quality policy debates. Sarah Sharpe, environmental health program director for Fresno Metro Ministries, said, “This information should be a wake- up call to all of us, especially our air board. It reminds us we need to get tougher on air pollution and make sure the public really understands how our health is impacted by air pollution.”
The Health Policy Institute, founded in 2002 to engage residents and decision makers on regional health policy issues, is housed under the Central California Center for Health and Human Services and Fresno State’s College of Health and Human Services.
For more information about the Institute and/or report, contact Capitman at 559.228.2157 or jcapitman@csufresno.edu.
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