Examining the Association between Residential Ambient Air Pollution and Pediatric Hospitalization due to Acute Respiratory Disease Across New York State

Project Summary Ambient air pollution is a major pediatric public health concern due to its ubiquity and increased exposure patterns

affiliated with climate change over the next decade. Despite significant improvements in overall levels of air pollution over the 20-years, 62% of children still live in areas that do not meet the US Environmental Protection Agency National Ambient Air Quality Standards. Consistent evidence has shown that ambient air pollution exposure is detrimental to

children's respiratory health due primarily to behavioral patterns and timing of exposure during a sensitive window of respiratory, endocrine, and immune system development, maturation, and modulation. Given the growing risk of present and future pandemics, and consistent exposure to environmental stimuli, understanding the role of air pollution

on pediatric respiratory disease is of pressing public health importance. While overall distributed and respiratory Minoritized poorer respiratory data pediatric discharge project Statewide estimates enrollment respiratory support using characteristics neighborhood-level aims young children in the United States

have a high burden of acute r espiratory diseases, r espiratory related hospital admissions are not equally across racial and ethnic populations. Rates of hospitalization are consistently greater among Black Latinx populations. These observed r acial and ethnic inequalities often remain after adjustment for traditional

risk f actors but are reduced when environmental and sociodemographic factors are considered. and low-income populations are more likely to reside in areas with greater levels of air pollution, quality built environment, and higher neighborhood deprivation, all factors which may impact acute disease in children. To bridge these gaps in knowledge, the proposed work will capitalize on existing

to examine the complex relationships between air pollution and neighborhood-level characteristics on acute respiratory disease. The proposed study is a secondary data analysis of administrative hospital data to examine environmental risk factors for pediatric acute respiratory disease. The proposed will utilize participant data that has already been collected as part of the New York Department of Health

Planning and Research Cooperative System (SPARCS) dataset. The addition of air pollution and neighborhood-level characteristics to the existing data does not require participant contact or new of participants. Specific outcomes of interest include asthma exacerbation, acute upper and lower infections, allergic rhinitis, and otitis media. This R03 will provide the protected time and programming

o accomplish the following aims: (1) Examine the effect of air pollution on acute respiratory disease a case-crossover study design, (2) Determine the effect of objective measures of neighborhood level on acute respiratory disease, and (3) Using a mixture model, evaluate which highly correlated characteristics and air pollution metrics are associated with acute espiratory disease. All

will assess whether these associations vary across age, race, ethnicity, and/or sex. t r Results from the proposed work will enhance the current knowledge by understanding the combined effect of air pollution and neighborhood-level exposures on respiratory disease in a generalizable sample of children