An investigation of the association

between traffic exposure and

diagnosis of asthma
in children
Background
Previous study indicated that children who live
near traffic have greater symptoms and
increased hospitalization for asthma.
The severity of asthma symptoms is also
associated with ambient benzene
concentration
Traffic is known to produce a mixture both
particulate and gaseous air pollution
VOCs is to be a large component of air pollution
The main source of VOCs is gasoline emissions both from
traffic and cold starts
The predominant of particulate matter is coarse fraction
2.5 m <PM< 10 m)
Anchorage : new metropolitan area, a culturally diverse
population, no geographic boundaries based on racial and
economic status, low income people.
Those are considered to have strongly association of asthma
to traffic

The study aimed:
To investigate the association between a
traffic-density related measure of exposure
and the prevalence of asthma among school
children 5 -7 years of age.
Method
Traffic exposure variable : It is measured by
calculating number of vehicle at a 100 m buffer zone
around of intersection of the road
(It was conducted by the student of traffic
engineering departement University of Alaska)
It is classified into three categories:
Low : <4x10
6
vm of traffic density
Medium : 4x10
6
to 8x10
6
vm of traffic density
High : > 8x10
6
vm of traffic density

Outcome variable : ever having had a diagnosis of arthma,
and they had been resident in current home for at least 1
year.
Others variables: demographic, symptoms, parental asthma,
smoker in the household, smoking in the house, housing type,
socioeconomic status.
Subjects : 1106 respondents with 75% of return rate
Analysis: there are two set of analysis
a) The main effect of traffic exposure
b) Considere the possibility of interaction with other variable
Statistical analysis: Logistic regression
There are three categories of traffic density lead the
consequences of analysis with low exposure as
referent group:
1) The OR of asthma comparing an individual
in the medium category to an individual in
the low category.
2) The OR of asthma comparing an individual
in the high category to an individual in
the low category.
Confounder variables: gender, paental asthma,
household smoker , income


Characteristics Asthma Total Asthma
Rate (%)
P-value
(X
2
test)
No Yes
Total 676 (89,4%) 80(10,6%) 756 10,6
Gender:
-Male
-Female

355(52,9%)
316(47,1%)
671

40(50,6%)
39(49,4%)
79

395
355
750

10,1
11,0


0,702
Parental asthma:
-No
-Yes

545(84,5%)
100(15,5%)
645

36(50,7%)
35(49,3%)
71

581
135
716

6,2
25,9

<0,001

Household smoker
-No
-Yes

475(70,9%)
195(29,1%)
670

52(65,0%)
28(35,0%)
80

527
233
750

9,9
12,6

0,276
Income (US)
< 20
20-49
50-100
>100


119(18,6%0
278(43,4%0
195(30,4%)
49(7,6%0
641

24(30,0%)
35(43,7%)
14(17,5%0
7(8,8%)
80

143
313
209
56
721

16,8
11,2
6,7
12,5
0,031
Baseline characteristics of children aged 5-7 years
Exposure Asthma Total Asthma
Rate (%)
No Yes
Low 471
(69,7%)
49
(61,2%)
520 9,4
Medium 161
(23,8%)
21
(26,3%)
182 11,5
High 44
(6,5%)
10
(12,5%
54 18,5
Total 676 80 776
Asthma rate based on traffic exposure level
Unadjusted (n=756) Adjusted (n=671)
OR(95% CI) P-value OR(95% CI) P-value
Exposure:
Low
Medium
High

Referent
1,25(0,73-2,15)
2,19(1,04-4,60)
0,139
Referent
1,40(0,77-2,55)
2,83(1,23-6,21)
0,056
Gender:
-Male
-Female

Referent
1,06(0,62-1,78)
0,843
Parental asthma:
-No
-Yes

Referent
5,14(3,01-8,78)
<0,001

Household smoker
-No
-Yes

Referent
1,25(0,72-2,16)
0,439
Income (US)
< 20
20-49
50-100
>100






Referent
0,61(0,32-1,16)
0,40(0,18-0,89)
0,75(0,26-2,14)
0,143
Lgistic Regression analysis of the 100 m buffer based traffic axposure on asthme diagnosis
Interaction
Variable
Exposure
level
OR (95%CI) Overall P-
value
Parental Asthma:
No



Yes

-Low
-Medium
-High

-Low
-Medium
-High


R
2,43(1,12-5,28)
5,34(2,08-13,74)

R
0,66(0,25-1,74)
0,67(0,12-3,69)
0,01
Household smoker:
No



Yes

-Low
-Medium
-High

-Low
-Medium
-High


R
1,72(0,83-3,56)
1,85(0,6-5,73)

R
0,87(0,28-2,67)
5,58(1,59-19,61)

0,055
Stratified Analysis
Unadjusted
(n=756)
Adjusted (n=671)
OR(95% CI) P-value OR(95% CI) P-value
Exposure:
Low
Medium
High

Referent
1,25(0,73-2,15)
2,19(1,04-4,60)
0,139
Referent
1,40(0,77-2,55)
2,83(1,23-6,21)
0,056
Gender:
-Male
-Female

Referent
1,06(0,62-1,78)
0,843
Parental asthma:
-No
-Yes

Referent
5,14(3,01-8,78)
<0,001

Household
smoker
-No
-Yes

Referent
1,25(0,72-2,16)
0,439
Income (US)
< 20
20-49
50-100
>100






Referent
0,61(0,32-1,16)
0,40(0,18-0,89)
0,75(0,26-2,14)
0,143
Lgistic Regression analysis of confounder variable
Interaction
Variable
Exposure
level
OR (95%CI) Overall
P-value
Parental
Asthma:
No



Yes


-Low
-Medium
-High

-Low
-Medium
-High



R
2,43(1,12-5,28)
5,34(2,08-13,74)

R
0,66(0,25-1,74)
0,67(0,12-3,69)
0,01
Household
smoker:
No



Yes


-Low
-Medium
-High

-Low
-Medium
-High



R
1,72(0,83-3,56)
1,85(0,6-5,73)

R
0,87(0,28-2,67)
5,58(1,59-19,61)

0,055