Synergistic Effects of Traffic-Related Air Pollution and Exposure to Violence on Urban Asthma Etiology

• DOI: 10.1289/ehp.9863
• Publication Date: 2007-03-22T17:22:44Z
• Authors: Jane E. Clougherty; Jonathan I. Levy; Laura D. Kubzansky; P. Barry Ryan; Shakira Franco Su...; Marina Jacobson C...; Rosalind J. Wright
• Keywords: Etiology; Stressor

BackgroundDisproportionate life stress and consequent physiologic alteration (i.e., immune dysregulation) has been proposed as a major pathway linking socioeconomic position, environmental exposures, health disparities. Asthma, for example, disproportionately affects lower-income urban communities, where air pollution social stressors may be elevated.ObjectivesWe aimed to examine the role of exposure violence (ETV), chronic stressor, in altering susceptibility traffic-related asthma etiology.MethodsWe developed geographic information systems (GIS)–based models retrospectively estimate residential exposures 413 children community-based pregnancy cohort, recruited East Boston, Massachusetts, between 1987 1993, using monthly nitrogen dioxide measurements 13 sites over 18 years. We merged estimates with questionnaire data on lifetime ETV examined effects both childhood etiology.ResultsCorrecting potential confounders, we found an elevated risk 1-SD (4.3 ppb) increase NO2 solely among above-median [odds ratio (OR) = 1.63; 95% confidence interval (CI), 1.14–2.33)]. Among always living same community, lesser measurement error, this association was magnified (OR 2.40; CI, 1.48–3.88). Of multiple periods, year-of-diagnosis most predictive outcomes.ConclusionsWe exposed violence. Future studies should consider socially patterned susceptibility, common spatial distributions physical factors, synergies these. Prospective assessment help determine causal pathways critical periods.