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Johns Hopkins study links exposure to coarse particulate matter to increased risk of asthma in children

Researchers at the Johns Hopkins University report that coarse particulate matter—created by physical processes such as tire and break wear, agricultural tilling, salt spray and dust created in manufacturing—appears to put children at greater risk for asthma, independent of exposure to fine particulate pollution. A paper on the work will be published in the American Journal of Respiratory and Critical Care Medicine.

Coarse particulate matter (PM10-2.5) measures from 2.5 to 10 micrometers; fine particulate pollution (PM2.5) measure 2.5 micrometers or smaller. The authors noted that there is substantial evidence that PM2.5 impacts respiratory and cardiovascular health, and this is why the Environmental Protection Agency monitors and regulates fine particulate pollution.

We did this study to understand whether, in addition to PM2.5, coarse particulate matter contributes to asthma development and morbidity. The most recent assessment by the EPA concluded that there wasn’t enough data to say one way or another whether PM10-2.5 causes negative health effects.

—Corinne A. Keet, MD, PhD, lead study author and associate professor of pediatric allergy and immunology at Johns Hopkins University School of Medicine

The researchers analyzed the records of 7,810,025 children (age 5 to 20) living across the country who were enrolled in Medicaid over a two-year period, 2009-2010. The researchers adjusted their findings for race and ethnicity, sex, age, poverty, education and how urban the neighborhood the children lived in was. The researchers also accounted for PM2.5.

The study found for each microgram/m3 increase in PM10-2.5:

  • asthma diagnosis increased by 0.6%;

  • ER visits for asthma increased by 1.7%; and

  • hospitalizations for asthma increased by 2.3%.

These findings were even stronger for children 11 and younger. The authors speculate that the stronger association is a result of asthma typically developing at younger ages and that young children are more likely to spend time outdoors and be harmed by air pollution.

The authors said that study limitations include the fact that there are few locations that monitor PM10-2.5. Most monitors measure only PM2.5, which the current study found was even more likely to be associated with an asthma diagnosis, ER visits and hospitalizations. The researchers used statistical methods to predict concentrations of PM10-2.5 across the U.S. This allowed them to study such a large number of children, including those who do not live near a monitor.

According to the American College of Allergy, Asthma & Immunology, an estimated 7.1 million children have asthma. Asthma is the most common chronic illness in childhood and accounts for 13.8 million missed school days each year.

Dr. Keet noted that the EPA is currently conducting a comprehensive review of the science related to the health effects of particulate matter as mandated by the Clean Air Act.

Reductions in PM2.5 have led to improvements in childhood respiratory health, but there is still a great burden of asthma in children. Our findings, along with others, suggest that PM10-2.5 likely contributes to asthma, too, and that regulation and monitoring of coarse particulate matter should be considered.

—Dr. Keet



With more and more people living in polluted cities, no wonder the cost of public health care programs keep going up and life expectancy has reached a plateau in many countries and may even go down in highly polluted places.

Very costly doctors and lab specialist may have to be replaced with smart robots in the near future to keep health care cost from rising too fast.

People disabled with incurable illnesses may be allow to select reduced treatments or none at all.

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