Modeling of Regional Climate Change Effects on Ground-Level Ozone and Childhood Asthma

doi:10.1016/j.amepre.2011.04.017

American Journal of Preventive Medicine

Volume 41, Issue 3, September 2011, Pages 251-257

https://doi.org/10.1016/j.amepre.2011.04.017 Get rights and content

Background

The adverse respiratory effects of ground-level ozone are well established. Ozone is the air pollutant most consistently projected to increase under future climate change.

Purpose

To project future pediatric asthma emergency department visits associated with ground-level ozone changes, comparing 1990s to 2020s.

Methods

This study assessed future numbers of asthma emergency department visits for children aged 0–17 years using (1) baseline New York City metropolitan area emergency department rates; (2) a dose–response relationship between ozone levels and pediatric asthma emergency department visits; and (3) projected daily 8-hour maximum ozone concentrations for the 2020s as simulated by a global-to-regional climate change and atmospheric chemistry model. Sensitivity analyses included population projections and ozone precursor changes. This analysis occurred in 2010.

Results

In this model, climate change could cause an increase in regional summer ozone-related asthma emergency department visits for children aged 0–17 years of 7.3% across the New York City metropolitan region by the 2020s. This effect diminished with inclusion of ozone precursor changes. When population growth is included, the projections of morbidity related to ozone are even larger.

Conclusions

The results of this analysis demonstrate that the use of regional climate and atmospheric chemistry models make possible the projection of local climate change health effects for specific age groups and specific disease outcomes, such as emergency department visits for asthma. Efforts should be made to improve on this type of modeling to inform local and wider-scale climate change mitigation and adaptation policy.

Introduction

Asthma, the most common chronic disease seen in pediatrics, is a genetic and environmental disorder.1, 2 The lungs are exposed to air pollution more than other organ systems particularly for children because of their increased minute ventilation compared to adults. As such, asthma exacerbations may be viewed as the “canary in the coal mine” for children's environmental health. In recent years, public health literature has highlighted respiratory illness as a potential future health impact related to climate change.3, 4, 5, 6, 7 However, projections of such health impacts remain uncommon for regional morbidity projections, such as asthma outcomes.⁸ Although some studies have modeled regional climate change–related mortality9, 10 and global morbidity,11, 12 no models to date have produced regional projections of future pediatric asthma related to climate-driven changes in the U.S.

Climate change through both temperature and wind-pattern changes is projected to affect multiple air-pollutant levels and specifically ground-level ozone (O₃).¹³ Ozone is a secondary pollutant formed through photochemical reactions involving other pollutants such as nitrogen oxides (NO_x) and volatile organic chemicals (VOC).¹⁴ Acute ground-level O₃ exposure is linked to childhood respiratory illness,¹⁵ exacerbations of asthma¹⁶ and, more specifically, increased emergency department visits for asthma.17, 18, 19, 20, 21 For example, during the Atlanta Olympics in 1996 when peak daily O₃ dropped 28%, there was an 11% reduction in pediatric emergency department visits for asthma and an over-40% reduction in acute care asthma events not seen with non-asthma acute care events.¹⁷ Asthma emergency department visits are one manifestation of uncontrolled asthma that is associated with both direct (services and medication) and indirect (such as missed work by parents) costs.22, 23 The objective of the present study was to demonstrate one method of projecting climate-driven, ozone-related pediatric asthma effects for the 2020s in an urban area of the U.S.

Section snippets

Climate Change and O₃ Modeling

Projections of ground-level O₃ were developed on a 36 × 36-km grid over the New York City metropolitan area by linking models for global climate, regional climate, and regional air quality.24, 25, 26, 27 Such linkages are necessary to be able to project local future conditions and have been used previously for future health projections.9, 10 Briefly, global climate was modeled using the Goddard Institute for Space Studies general circulation model. The regional climate model used the Penn

Health Outcomes Assessment

County-specific O₃ concentrations and the associated pediatric morbidity projections for emergency department visits for the primary HOA appear in Table 1. Percentage changes in emergency department visits between the 1990s and 2020s for the HOA model appear in Figure 1. The calculations of projections for O₃-related asthma morbidity include the 95% CI from the epidemiologic study of Tolbert et al.²¹ The O₃ projections for average summer daily 8-hour maximum concentrations under the HOA

Discussion

The results of this assessment suggest that, compared to the 1990s, by the 2020s climate change could cause a median increase of 7.3% in regional summer O₃-related asthma emergency department visits for children aged 0–17 years across the New York City metropolitan region. However, when examining individual counties, O₃-related emergency department increases ranged from 5.2% to 10.2%. Actual O₃ precursor emissions have been decreasing as opposed to increasing—as detailed by U.S. EPA⁴⁰—and

Conclusion

These projected effects add an important contribution to current research regarding climate-related disease in children. As the first model of climate-related, regional, pediatric morbidity, this study not only demonstrates an important modeling approach but also provides some quantitative projections to which future work can add and compare. Adaptation measures to climate change that work to reduce ozone levels should be coupled with ongoing efforts for better disease management of asthma. The

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Research articleModeling of Regional Climate Change Effects on Ground-Level Ozone and Childhood Asthma

Background

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Climate Change and O3 Modeling

Health Outcomes Assessment

Discussion

Conclusion

J Allergy Clin Immunol

Lancet

Am J Prev Med

Am J Prev Med

J Allergy Clin Immunol

Environ Res

Atmos Environ

J Allergy Clin Immunol

Ann Allergy Asthma Immunol

Environ Res

Status of childhood asthma in the U.S., 1980–2007

Pediatrics

Global climate change and children's health

Pediatrics

Climate change and human health

N Engl J Med

The international response to climate change: an agenda for global health

JAMA

Climate change, ambient ozone, and health in 50 U.S. cities

Climatic Change

Projecting heat-related mortality impacts under a changing climate in the New York City region

Am J Public Health

Assessing ozone-related health impacts under a changing climate

Environ Health Perspect

Global climate change

Global burden of disease 2004 Update

Ambient air pollution: respiratory hazards to children

Pediatrics

Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma

JAMA

Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada

Environ Health Perspect

Association between hospital emergency visits for asthma and air pollution in Valencia, Spain

Occup Environ Med

Air quality and pediatric emergency room visits for asthma in Atlanta, Georgia, USA

Am J Epidemiol

Economic burden of asthma: a systematic review

BMC Pulm Med

Research article
Modeling of Regional Climate Change Effects on Ground-Level Ozone and Childhood Asthma

Climate Change and O₃ Modeling