BackgroundLiving near traffic has been associated with asthma and other respiratory symptoms. Most studies, however, have been conducted in areas with high background levels of ambient air pollution, making it challenging to isolate an independent effect of traffic. Additionally, most investigations have used surrogates of exposure, and few have measured traffic pollutants directly as part of the study.ObjectiveWe conducted a cross-sectional study of current asthma and other respiratory symptoms in children (n = 1,080) living at varying distances from high-traffic roads in the San Francisco Bay Area, California, a highly urbanized region characterized by good regional air quality due to coastal breezes.MethodsWe obtained health information and home environmental factors by parental questionnaire. We assessed exposure with several measures of residential proximity to traffic calculated using geographic information systems, including traffic within a given radius and distance to major roads. We also measured traffic-related pollutants (nitrogen oxides and nitrogen dioxide) for a subset of households to determine how well traffic metrics correlated with measured traffic pollutants.ResultsUsing multivariate logistic regression analyses, we found associations between current asthma and residential proximity to traffic. For several traffic metrics, children whose residences were in the highest quintile of exposure had approximately twice the adjusted odds of current asthma (i.e., asthma episode in the preceeding 12 months) compared with children whose residences were within the lowest quintile. The highest risks were among those living within 75 m of a freeway/highway. Most traffic metrics correlated moderately well with actual pollutant measurements.ConclusionOur findings provide evidence that even in an area with good regional air quality, proximity to traffic is associated with adverse respiratory health effects in children.
Structural fumigations using sulfuryl fluoride for the extermination of dry-wood termites are conducted by the thousands in California and other warm-weather states. Sulfuryl fluoride is an odorless gas that targets the nervous system and can cause respiratory irritation, pulmonary edema, nausea, vomiting, seizures, and death. Structural voids or compartments such as wall sockets, crawl spaces, cabinets, or cells in air mattresses may create ongoing exposure after a structure has been certified as safe. The authors describe a case of potential sulfuryl fluoride exposure to a family following home fumigation. Despite regulation, sulfuryl fluoride poisonings from structural fumigations continue to occur. This article examines the physical characteristics of sulfuryl fluoride and the regulatory oversight of its application, in an effort to understand how and why these poisonings happen. Increasing aeration times of fumigated structures, overseeing monitoring efficacy, and using technology to capture clearance data could reduce sulfuryl fluoride exposure and illness.
ISEE-521 Introduction: Several epidemiological studies have found associations between residential proximity to busy roads and adverse health effects. We recently conducted a school-based, cross-sectional study to examine respiratory health among children (8 to 11 years) living and attending schools at varying distances from high-traffic roads. Air pollutants, including particulate matter (PM10, PM2.5), black carbon (BC), and nitrogen oxides (NOX, NO,), were measured at each of ten schools. We found associations between traffic pollutants (especially BC, NOX, and NO {NOX- NO2}) and asthma and bronchitis episodes in the past 12 months, using a two-stage hierarchical model. In our analysis to date, we used pollutant levels measured at the school sites as estimates of the children’s exposure to traffic emissions. To refine exposure estimates, we obtained additional within-neighborhood measurements of NOX and NO2. We report here on the development of new measures of residential traffic exposure based on geographic information systems (GIS) technology. These metrics will then be compared with observed traffic pollutant concentrations. Methods: We utilize information on both school or residential address and traffic data using geographic information systems (GIS) technology to calculate various traffic metrics, including closest traffic volume within a given buffer radius, maximum traffic volume, and distance-weighted traffic density. Second, we develop a model incorporating prevailing wind direction and distance. Third, we present results of a spatial regression model similar to that developed by Brauer et al. (Epidemiology 2003; 14:228-39). This model uses information on several factors, such as local traffic density, distance to the highway and traffic counts, to explain the variation in school and neighborhood NOx/NO2 concentrations that were collected. Our last exposure measure is based on self-reported assessment of traffic from our intake questionnaires. Results: The GIS-based traffic metrics and spatial regression models will be presented and compared with previous results obtained using school-based or residential exposure measurements. Ultimately, these measures will be used to further explore associations between both bronchitis and asthma symptoms. Discussion: Different metrics of exposure to traffic pollutants can be used to explore exposure misclassification. By reducing measurement error, we will be able to elucidate more clearly the relationships of traffic to respiratory health outcomes. The results will help determine the relative importance of different approaches to refining exposure estimates and, in so doing, will provide methodological guidance for future traffic studies. Information generated from this study will be useful for both ambient air quality standard-setting and pollution control strategies.
On August 24, 2014, at 3:20 a.m., a magnitude 6.0 earthquake struck California, with its epicenter in Napa County (1). The earthquake was the largest to affect the San Francisco Bay area in 25 years and caused significant damage in Napa and Solano counties, including widespread power outages, five residential fires, and damage to roadways, waterlines, and 1,600 buildings (2). Two deaths resulted (2). On August 25, Napa County Public Health asked the California Department of Public Health (CDPH) for assistance in assessing postdisaster health effects, including earthquake-related injuries and effects on mental health. On September 23, Solano County Public Health requested similar assistance. A household-level Community Assessment for Public Health Emergency Response (CASPER) was conducted for these counties in two cities (Napa, 3 weeks after the earthquake, and Vallejo, 6 weeks after the earthquake). Among households reporting injuries, a substantial proportion (48% in Napa and 37% in western Vallejo) reported that the injuries occurred during the cleanup period, suggesting that increased messaging on safety precautions after a disaster might be needed. One fifth of respondents overall (27% in Napa and 9% in western Vallejo) reported one or more traumatic psychological exposures in their households. These findings were used by Napa County Mental Health to guide immediate-term mental health resource allocations and to conduct public training sessions and education campaigns to support persons with mental health risks following the earthquake. In addition, to promote community resilience and future earthquake preparedness, Napa County Public Health subsequently conducted community events on the earthquake anniversary and provided outreach workers with psychological first aid training.
Public, private, government, and university stakeholders have focused increasing attention on children's environmental health. Priority areas have been healthy school environments including indoor air and environmental quality (IEQ); susceptibilities of children to environmental factors and associated illness; and, understanding exposure to biological, chemical, and physical agents. As multidisciplinary teams, studies and intervention demonstrations in California public schools were conducted. A common theme among them was a ''partnership,'' the collaboration between stakeholders from the aforementioned sectors. Federal funding and local bond measures for planning, maintenance, and modernization of school facilities have recently been authorized. Therefore, beneficial ''partnerships'' should be established to conduct needed IEQ, environmental health, and productivity research, development and demonstration. This commentary describes benefits for stakeholders and five strategies for future effective collaborations.
In June 2015, personnel from California's Contra Costa Health Services Environmental Health and Hazardous Materials (hazmat) divisions were alerted to a possible chemical release at a swimming pool in an outdoor municipal water park. Approximately 50 bathers were in the pool when symptoms began; 34 (68%) experienced vomiting, coughing, or eye irritation. Among these persons, 17 (50%) were treated at the scene by Contra Costa's Emergency Medical Services (EMS) and released, and 17 (50%) were transported to local emergency departments; five patients also were evaluated later at an emergency department or by a primary medical provider. Environmental staff members determined that a chemical controller malfunction had allowed sodium hypochlorite and muriatic acid (hydrochloric acid) solutions to be injected into the main pool recirculation line while the recirculation pump was off; when the main recirculation pump was restarted, toxic chlorine gas (generated by the reaction of concentrated sodium hypochlorite and muriatic acid) was released into the pool. A review of 2008-2015 California pesticide exposure records identified eight additional such instances of toxic chlorine gas releases at public aquatic venues caused by equipment failure or human error that sickened 156 persons. Chemical exposures at public aquatic venues can be prevented by proper handling, storage, and monitoring of pool chemicals; appropriate equipment operation and maintenance; training of pool operators and staff members on pool chemical safety; and reporting of chemical exposures.
This study examines all intimate partner homicides in California during 1996 (N=186), and differences between intimate partner homicides with and without perpetrator suicide are compared. The study found that 40 percent of perpetrators committed suicide subsequent to the homicide. Variables examined in the analysis include type of weapon used, race, age, sex of perpetrators and victims, and location of the homicide. Significant differences were found between homicides with perpetrator suicide and those without. The results lend support to previous research suggesting that intimate partner homicide and homicide followed by suicide have different characteristics and possibly distinct etiologies.
