New Research published from the CHS: Less pollution = improvement in children’s respiratory health

Bronchitic symptoms on the decline as pollution levels drop in Los Angeles region over the past two decades  #CleanAir

PRESS COVERAGE: Press Enterprise, New York Times, U.S.News, HealthDay, United Press International, Medical News Today, Eureka Alert
JAMA Coverage:  News Release and VideoAuthor Interview Video
Storify: Press and social media coverage of this study all in one place.

A USC study that tracked Southern California children over a 20 year period has found they now have significantly fewer respiratory symptoms as a result of improved air quality.

The finding expands on the landmark USC Children’s Health Study, which a year ago reported that kids’ lungs had grown stronger over the past 20 years as pollution levels in the Los Angeles Basin declined. In the current study, USC researchers examined a health issue that makes many parents anxious while pulling at their pocketbooks: bronchitic symptoms that could land otherwise healthy children in a doctor’s office or hospital.

The research appears in the April 12, 2016 issue of the Journal of the American Medical Association.

To assess respiratory symptoms, USC scientists studied children in eight California communities and defined bronchitic symptoms over the preceding year as a daily cough for at least three consecutive months, congestion or phlegm not related to a cold, or inflammation of the mucous membranes, according to Kiros Berhane, lead author and a professor of preventive medicine at the Keck School of Medicine of USC.

“This is one of the few times that we have been able to report good news, and this is very likely a direct result of the science-­‐‑based policies that have been put in place,” Berhane said. “The message that clean air leads to better health in children should be taken seriously because it has implications for how we live and how productive we become.”

The study, published April 12 in the Journal of the American Medical Association, followed 4,602 children in three cohorts as they aged from 5 to 18. During 1993 to 2012, children and their parents from Long Beach, San Dimas, Upland, Riverside, Mira Loma, Lake Elsinore, Alpine and Santa Maria answered questionnaires about children’s health. Air quality was continuously monitored in each community.

“Because of the wide variations in ambient pollution levels among the eight California communities we analyzed, these findings are applicable to other parts of the United States and maybe other parts of the world as well,” Berhane said, adding the results could help with asthma management and the overall respiratory health of children.

How much children’s respiratory health improved

Because bronchitic symptoms are usually about four times higher in children with asthma, the scientists examined associations of air pollution reduction with bronchitic symptoms separately for kids with and without asthma. Researchers also adjusted their analyses for age, gender, race or ethnicity, secondhand tobacco smoke and presence of cockroaches in the home.

“It is important to note that while reductions in bronchitic symptoms were larger in children with asthma, they were still substantial and significant in children without asthma as well — indicating that all children have benefited from the improvement in air quality over the past 20 years,” Berhane said.

The study found that tiny particles called particulate matter 2.5 (PM 2.5) — which can penetrate deep into lungs and cause serious health problems — dropped by 47 percent from 1992 to 2011 in the study region. USC researchers were able to associate cleaner air with improved children’s respiratory health. Kids with asthma were 32 percent less likely to suffer from bronchitic symptoms, and children without asthma experienced a 21 percent reduction in these respiratory problems.

Moreover, nitrogen dioxide, which can reduce resistance to respiratory infections, decreased by 49 percent in the same two decades. USC researchers linked the drop in nitrogen dioxide with a 21 percent decrease of bronchitic symptoms in children with asthma and a 16 percent decline of bronchitic symptoms in kids without asthma.

“This type of data is important for policymaking and for how clinicians would advise their patients,” Berhane said.

The cost of asthma and sick children

About 1 in 10 children in the United States had asthma in 2009, according to the Centers for Disease Control and Prevention. Medical expenses associated with asthma amounted to $50.1 billion in 2007 and cost the nation about $3,300 per person each year.

“Changes in children’s respiratory health have a ripple effect,” Berhane said. “A child may stay home because of severe bronchitic symptoms. That could mean parents have to call in sick or arrange for a caregiver. Beyond quality of life, childhood asthma and bronchitic symptoms take a toll on children’s school attendance, parental productivity and society in general.”

Asthma is the cause for almost 2 million emergency room visits each year, according to the Asthma and Allergy Foundation of America. Each year, this respiratory condition is the reason for more than 14 million doctor visits and about 439,000 hospital stays.

Frank Gilliland, senior author and a professor of preventive medicine at Keck Medicine of USC, said the USC Children’s Health Study is a unique examination because it has been able to follow children for so many years.

“Asthma is the most common chronic disease of childhood, so the reduction of these symptoms by 16 to 32 percent is a big deal,” Gilliland said. “We studied longitudinal cohorts of children for 20 years using consistent methods and found that decreased levels of air pollutants were associated with a marked decrease in bronchitic-­‐‑related symptoms in children both with and without asthma. No other study has been able to accomplish this.”

Pollution and policy

California cities have consistently topped the American Lung Association’s annual list of most polluted cities by ozone or particulate matter pollution. Historically, Southern California has reported high levels of ambient air pollution because of emissions from vehicles, industrial sources and two of the nation’s largest ports.

“While the reduction in ambient air pollution has been observed during the past 20 years, it was most marked after 2000 and is very likely due to policies that were put in place,” Berhane said. “Even though this is very encouraging, there is still room for improvement. We must recognize that in some cases, the ozone and particulate matter levels in Southern California are still in violation of federal standards.”

Some California regulatory policies that have been implemented include the Low-Emission Vehicle Program, a risk-reduction plan for diesel fueled engines and vehicles, and pollution controls at the ports of Los Angeles and Long Beach.

For many years, environmental epidemiologists have reported adverse health effects associated with increasingly polluted air. So the ability to report that Southern California has been on the path to cleaner air and that this reduction in air pollution has led to significant improvement in children’s health is a welcome change, Gilliland said.

Berhane added: “But we must not get complacent. We expect more cars on the road, more ships at our ports and more economic activities in the region. Even if we maintain the current policies and practices in environmental protection, pollution levels could start to rise again because of more cars and economic activities. We have to stay vigilant so that we do not lose current gains in air quality and the associated improvements in our children’s health.”

USC strives to conduct research that could have a global impact. This study was supported by the National Institute of Environmental Health Sciences, the Health Effects Institute and the California Air Resources Board.

Press Release: by Zen Vuong, USC Media Relations

# # #
Kiros Berhane, PhD; Chih-Chieh Chang, PhD; RobMcConnell, MD;W. James Gauderman, PhD; Edward Avol, MS; Ed Rapapport, MPH; Robert Urman, PhD; Fred Lurmann, MS; Frank Gilliland, MD, PhD. Association of Changes in Air Quality With Bronchitic Symptoms in Children in California, 1993-2012. JAMA. 2016;315(14):1491-1501. doi:10.1001/jama.2016.3444

Center member McConnell: Speaker on April 13, NIEHS/EPA Children’s Centers Webinar Series

NIEHS/EPA Children’s Centers Webinar Series: Stress, Chemical and Non-Chemical Exposures

Topic: Stress, Chemical and Non-Chemical Exposures
Date: Wednesday, April 13, 2016
Time: 10:00-11:30 a.m. PDT / 1 – 2:30 p.m. EDT

FREE: Register Now: CLICK HERE

Speakers:
•    Dr. Rob McConnell, University of Southern California
•    Dr. Greg Diette, Johns Hopkins University
•    Dr. Rachel Morello-Frosch, University of California, Berkeley

Discussion Moderator:
•    Dr. Mark Miller, University of California, San Francisco

The NIEHS/EPA Children’s Centers Program
For many reasons, children are likely to be more vulnerable than adults to the effects of environmental contaminants. To better understand the effects of these exposures on children’s health, the NIEHS/EPA Children’s Environmental Health and Disease Prevention Research Centers (Children’s Centers) were established in 1998 to explore ways to reduce children’s health risks from environmental factors. The webinar series, co-sponsored by the EPA Office of Children’s Health Protection and the National Center for Environmental Research, features presentations and interactive discussions on recent findings and new developments in children’s environmental health research.

The NIEHS/EPA Children’s Centers are part of EPA’s Sustainable and Healthy Communities (SHC) Research Program. The SHC Research Program provides useful science and tools for decision makers at all levels to help communities advance sustainability as well as achieve regulatory compliance. SHC is collaborating with partners to conduct research that will result in science-based knowledge to guide decisions at the federal, regional, state and community level that will better sustain a healthy society and environment in America’s communities.

SCEHSC Center members involved in KPCC Story: More than 150 LA child care centers dangerously close to freeways

Local KPCC reporter, Deepa Fernandez (Early Childhood Development Correspondent) approached SCEHSC staff and researchers last year to inquire about air pollution monitoring and health effects of near roadway air pollution on children. Today her feature story about childcare centers in Los Angeles in close proximity to freeways was published.We are proud to not only have our center members quoted in the story, but community partners as well.

Deepa Fernandez, KPCC

Culver City writer Tracey Moore loved everything about her daughter’s daycare. It was close to her family’s house, included some Spanish immersion, and her young child was smitten with the staff.

So when the owner informed parents she was moving, there was unanimous consensus among families that they would all follow her.

But when Moore saw the new daycare location, she was devastated: “It’s a side street that dead ends right at the freeway,” she recalled, “and the preschool is about a stone’s throw [away].”

Every day, more than 300,000 cars and trucks rumble through that section of the 405, according to CalTrans data for 2014 – making it one of the most highly-trafficked spots in Los Angeles. Moore didn’t know that specific statistic, but she could see the traffic and was concerned about what she called the “invisible ribbon of particles” drifting off the freeway from cars and trucks directly into the yard of the day care. Read more here

Map: Where child care facilities are next to highways

New Infographic on the Health Effects of Diesel

The Community Outreach team at USC Environmental Health Centers has developed this infographic to provide an overview of the research on health risks from diesel exhaust.

The infographic includes interactive links that lead to useful information. For example, in the HOW section, the health effects are linked to specific research articles. Links to websites and social media are also interactive. Please share widely!

Click on the images below to go to the full version of the infographic in both English and Spanish.

 

 

Empowerment Congress 2016 Youth Summit

“The Case for Open Space” was the theme of the Youth Summit workshop on January 16, 2016, designed for youth to give their input on the needs and opportunities for parks and recreational spaces in urban Los Angeles. The Outreach program helps coordinate the Environmental Committee of the Empowerment Congress, a civic engagement program of County Supervisor Mark Ridley-Thomas.

Eighty-five young adults from 8 organizations participated in the event at the University of Southern California, which kicked off with a keynote from D’artganan Scorza of the Social Justice Learning Institute on the power and importance of getting involved in changing the space around us.

Urban planner James Rojas then led a hands-on activity called “Place It!” where each participant built their ideal park out of small objects. Many of the youth designed displays featured gardens and lush green spaces, places for families to walk and play, community centers, and many features. To connect students with current engagement efforts, Rita Robinson with the Department of Parks and Recreation led an activity similar to a community meeting for the Los Angeles County Park Needs Assessment.

Participants went through information and maps from their neighborhoods, and ranked their top priorities for parks.  Participants were thinking of their families and whole community when they put at the top of the list: accessibility, changing stations, children’s playgrounds,  bike lanes/paths, bike rental, community center, community garden, dog area/park, exercise equipment, pond, lighting, nursing/changing stations, picnic area, pool/splash pad, security features, trees, walking/jogging/hiking paths, and water fountains.

Comments from Mr. Rojas help to summarize the day:
“From the youth comments it was transformative for them. We were able to tap into knowledge that they didn’t even know they had!  This gives them a new way of seeing and articulating their community needs, challenges, and opportunities from the built environment they experience every day. This empowers them to get involved, engage and become the future leaders in their community.”

 

Community Outreach recognized for involvement in change: Diesel emissions and health

NIEHS features our Center’s outreach program, under the long-time direction of Andrea Hricko, along with THE Impact Project and the Moving Forward Network. The article highlights community-driven nationwide efforts to clean the air and building healthier communities near ports, railyards and goods movement operations.

Click here to read more.

 

USC Funded by NIH/Fogarty: GEOHealth Hub for Research and Training in eastern Africa

October 8, 2015: NIH Fogarty International Center announced they are investing $21 million in partnerships between research institutions in the US and Canada  to establish Global Environmental and Occupational Health (GEOHealth) Hubs in developing countries.

Through the leadership of Dr. Kiros Berhane, Professor in the Department of Preventive Medicine at the Keck School of Medicine and Dr. Jon Samet, Distinguished Professor and Chair of the Department of Preventive Medicine in the Keck School of Medicine, USC will be partnering with Addis Ababa University (Ethiopia) for the eastern Africa portion of the work which will include air pollution monitoring work in Ethiopia, Kenya, Rwanda and Uganda. The air pollution monitoring network and surrounding work that is a part of this hub is modeled after the longitudinal Southern California Children’s Health study of which Dr. Berhane has been an investigator. The hub will have two main components dealing with training and research activities to be led by USC and Addis Ababa University (Ethiopia) respectively. The research projects will be conducted primarily by Eastern African researchers.

Media coverage:
USC Press Release here.
NIH/Fogarty PRESS RELEASE and related resources and information about the GEOHealth Hub project can be found here.

For background on this project at USC,see this blog post detailing part of the air pollution monitoring network planning process that took place back in April 2014 when Worku Tefera, researcher from Ethiopia visited USC.

GEOHealth Hub team in Ethiopia during a planning meeting in 2013.

Worku Tefera (right), Steve Howland, and Suresh Ratnam pictured on the roof of the Soto Street building at USC HSC disassembling an air pollution monitor.