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Title: Association of short-term exposure to ground-level ozone and respiratory outpatient clinic visits in a rural location – Sublette County, Wyoming, 2008–2011

Objective: Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008–2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. Methods: Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008–December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0–3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. Results: The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47±8 ppb. The unconstrained distributed lag of 0–3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990–1.012); results for lags 0, 2, and 3 days were consistent with themore » null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994–1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. Conclusions: The results demonstrate an association of increasing ground-level ozone with an increase in clinic visits for adverse respiratory-related effects in the following day (lag day 1) in Sublette County; the magnitude was strongest during the winter months; this association during the winter months in a rural location warrants further investigation. - Highlights: • We assessed elevated ground-level ozone in frontier Sublette County, Wyoming. • Ground-level ozone concentrations were moderately to highly correlated between stations. • Adverse respiratory-related clinic visits occurred year round at lag 1. • Strongest association of clinic visits was in the coldest months at lag 1.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ;  [8] ;  [9]
  1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA (United States)
  2. (United States)
  3. Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523 (United States)
  4. Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States)
  5. Field Support Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States)
  6. Chronic Disease Epidemiologist, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States)
  7. Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 600 Clifton Road, NE, E-92, Atlanta, GA 30333 (United States)
  8. Air Pollution and Respiratory Disease Branch, Centers for Disease Control and Prevention, 600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States)
  9. Wyoming Department of Health, 101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States)
Publication Date:
OSTI Identifier:
22483274
Resource Type:
Journal Article
Resource Relation:
Journal Name: Environmental Research; Journal Volume: 137; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
54 ENVIRONMENTAL SCIENCES; ABUNDANCE; ADMINISTRATIVE PROCEDURES; AIR POLLUTION; COMMUNITIES; CONCENTRATION RATIO; ECOLOGICAL CONCENTRATION; GROUND LEVEL; HUMIDITY; OZONE; SEASONS; SENSITIVITY; URBAN AREAS; WYOMING