The Detroit Asthma Morbidity, Air Quality and Traffic (DAMAT) StudyEPA Grant Number: R833628
Title: The Detroit Asthma Morbidity, Air Quality and Traffic (DAMAT) Study
Investigators: Wahl, Robert L , Batterman, Stuart A. , Hultin, Mary Lee , Michalak, Anna , Mukherjee, Bhramar , Wasilevich, Elizabeth , Dombkowski, Kevin
Institution: Michigan Department of Community Health , School of Public Health and College of Engineering , University of Michigan - Ann Arbor
EPA Project Officer: Hahn, Intaek
Project Period: September 30, 2007 through September 29, 2010 (Extended to September 29, 2011)
Project Amount: $499,777
RFA: Development of Environmental Health Outcome Indicators (2006) RFA Text | Recipients Lists
Research Category: Health Effects , Health
Pediatric asthma is an important and growing public health problem known to be associated with exposure to air pollutants and potentially without a concentration threshold for particulate matter exposure. Objective: Develop and evaluate a direct health indicator of pediatric asthma morbidity resulting from exposure to ambient air pollutants using an epidemiological approach that merges existing datasets and incorporates population susceptibility, exposure patterns, and other local conditions. Hypotheses: (1) Daily changes in asthma morbidity among the pediatric Medicaid population in Detroit are attributable to fluctuations in ambient air pollutant concentrations. (2) Daily changes in asthma morbidity can be separated into effects caused by regional and local emission sources. (3) Associations between air pollutants and asthma morbidity are strengthened by accounting for residential location and exposures due to traffic and industry-related pollutants. (4) The spatial pattern of asthma-related urgent care use relative to other pediatric claims is determined in part by exposure to traffic- and industry-related pollutants. (5) The developed indicators provide meaningful measures of health impacts that can inform decision-making and comparative impact assessments.
The DAMAT study will integrate: Medicaid data (pediatric asthma-related hospitalizations, emergency department visits and urgent care visits) among Detroit children from January 1, 2004 to December 31, 2006; geocoding data providing residence of children; air quality data from MDEQ; traffic data from the Michigan Department of Transportation; air emission data from the EPA Toxic Inventory Release System; and demographic data from the US Census. Following initial descriptive analyses, crude univariate analyses of urgent care outcomes and exposures 1-5 days prior to the daily counts will be completed. Longitudinal analyses using multivariate case-crossover Poisson models will relate daily asthma events to concentrations of ambient pollutants. Spatial analyses using case/control methods including multinominal multiple logistic regression models will evaluate whether children living in areas affected by traffic and industrial emissions have higher relative risks for severe asthma events. Using the asthma morbidity indicators, health impacts and uncertainties will be demonstrated for three emission/ concentration scenarios.
The study will demonstrate links between air pollutant exposure and adverse health outcomes, information needed to improve the understanding and effectiveness of environmental decision-making, including the evaluation of benefits and costs associated with further reductions in pollutant levels. The proposed indicator can help to translate environmental information into terms that are meaningful to managers, policy-makers, and the public.