Air Pollutants and Asthma Hospitalization in the Medicaid Population

• DOI: 10.1164/rccm.202107-1596oc
• Publication Date: 2022-01-24T19:25:30Z
• Authors: Yaguang Wei; Xinye Qiu; Matthew Benjamin ...; Mahdieh Danesh Yazdi; Kanhua Yin; Longxiang Li; Adjani A. Peralta; Cuicui Wang; Petros Koutrakis; Antonella Zanobetti; Francesca Dominici; Joel D. Schwartz
• Keywords: Air Pollutants; Medicaid; Nitrogen Dioxide; Environmental Exposure; Asthma; United States; Hospitalization; 03 medical and health sciences; Ozone; 0302 clinical medicine; Air Pollution; Humans; Particulate Matter

Rationale: Risk of asthma hospitalization and its disparities associated with air pollutant exposures are less clear within socioeconomically disadvantaged populations, particularly at low degrees exposure. Objectives: To assess effects short-term to fine particulate matter (particulate an aerodynamic diameter ⩽2.5 μm [PM2.5]), warm-season ozone (O3), nitrogen dioxide (NO2) on risk among national Medicaid beneficiaries, the most population in United States, test whether any subpopulations were higher risk. Methods: We constructed a time-stratified case-crossover dataset 1,627,002 hospitalizations during 2000–2012 estimated PM2.5, O3, NO2 exposures. then restricted analysis exposure below increasingly stringent thresholds. Furthermore, we tested effect modifications by individual- community-level characteristics. Measurements Main Results: Each 1-μg/m3 increase 1-ppb was 0.31% (95% confidence interval [CI], 0.24–0.37%), 0.10% CI, 0.05 − 0.15%), 0.28% 0.24 0.32%) hospitalization, respectively. Low-level PM2.5 beneficiaries only one study period or communities lower density, average body mass index, longer distance nearest hospital, greater neighborhood deprivation experienced Conclusions: Short-term increased even concentrations well standards. The subgroup differences suggested individual contextual factors contributed under