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Modification of Traffic-related Respiratory Response by Asthma Control in a Population of Car Commuters

Mirabelli, Maria C.a; Golan, Rachelc; Greenwald, Robyc; Raysoni, Amit U.c; Holguin, Fernandod; Kewada, Priyac; Winquist, Andreac; Flanders, W. Danab; Sarnat, Jeremy A.c

doi: 10.1097/EDE.0000000000000296
Air Pollution
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SDC

Background: Effects of traffic-related exposures on respiratory health are well documented, but little information is available about whether asthma control influences individual susceptibility. We analyzed data from the Atlanta Commuter Exposure study to evaluate modification of associations between rush-hour commuting, in- vehicle air pollution, and selected respiratory health outcomes by asthma control status.

Methods: Between 2009 and 2011, 39 adults participated in Atlanta Commuter Exposure, and each conducted two scripted rush-hour highway commutes. In-vehicle particulate components were measured during all commutes. Among adults with asthma, we evaluated asthma control by questionnaire and spirometry. Exhaled nitric oxide, forced expiratory volume in 1 second (FEV1), and other metrics of respiratory health were measured precommute and 0, 1, 2, and 3 hours postcommute. We used mixed effects linear regression to evaluate associations between commute-related exposures and postcommute changes in metrics of respiratory health by level of asthma control.

Results: We observed increased exhaled nitric oxide across all levels of asthma control compared with precommute measurements, with largest postcommute increases observed among participants with below-median asthma control (2 hours postcommute: 14.6% [95% confidence interval {CI} = 5.7, 24.2]; 3 hours postcommute: 19.5% [95% CI = 7.8, 32.5]). No associations between in-vehicle pollutants and percent of predicted FEV1 were observed, although higher PM2.5 was associated with lower FEV1 % predicted among participants with below-median asthma control (3 hours postcommute: –7.2 [95% CI = –11.8, –2.7]).

Conclusions: Level of asthma control may influence respiratory response to in-vehicle exposures experienced during rush-hour commuting.

Supplemental Digital Content is available in the text.

From the aAir Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA; bDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; cDepartment of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA; and dDivision of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.

Submitted 8 September 2014; accepted 26 March 2015.

The Atlanta Commuter Exposure (ACE-1) study received funding from the Air Pollution and Respiratory Health Branch of the National Center for Environmental Health, Centers for Disease Control and Prevention. R Golan gratefully acknowledges support by a post-doctoral fellowship from the Environment and Health Fund, Jerusalem, Israel.

The ACE-1 study was developed and implemented by Drs. Sarnat, Flanders, Golan, Greenwald, Raysoni, Winquist, and Ms. Kewada. Dr. Mirabelli developed the analysis plan, analyzed the data, and led the writing for this paper. All authors reviewed interim results, contributed to the interpretation of the data, and approved the final paper for submission.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors report no conflicts of interest.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com). This content is not peer-reviewed or copy-edited; it is the sole responsibility of the authors.

Correspondence: Maria C. Mirabelli, Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Building 106, Mailstop F-60, Atlanta, GA 30341. E-mail: zif7@cdc.gov.

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