THE USC CHILDRENS HEALTH STUDY

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THE USC CHILDRENS HEALTH STUDY

• Dr. Rob McConnell
• Professor of Preventive Medicine
• Keck School of Medicine
• University of Southern California (USC)
• Presentation to LBACA
• January 20, 2009

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Acknowledgments

• Ed Avol
• Kiros Berhane
• Scott Fruin
• Jim Gauderman
• Frank Gilliland
• Nino Kuenzli
• Fred Lurmann
• John Peters
• Duncan Thomas
• Our Field Team
• Parents and
• students

• NIEHS
• US EPA
• CARB
• South Coast AQMD
• National Health, Lung and Blood Institute
• Southern California Particle Center
• Hastings Foundation

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RESEARCH QUESTIONS

• What are the health effects of the air pollution
  we all breathe in Southern California?
• What are the health effects if you live close to
  a busy road or freeway near lots of traffic
  pollutants?

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CHS Communities
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• Annual lung function testing
• 4,000 4th graders
• Test every year until graduation from high
  school

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A Few of the Pollutants We Studied

• Nitrogen Dioxide (NO2) From cars, trucks, and
  other combustion sources
• Particulate Matter (PM) Tiny particles
• Elemental Carbon (EC) Found in particles and
  usually an indication of diesel exhaust

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What we were looking for

• If children live in a community with HIGH levels
  of a certain pollutant, would their lungs grow as
  fast as children who lived in less polluted
  communities?
• Lets look at Particulate Matter first

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How Small is Particulate Matter?
Hair cross section (60 mm)
Human Hair (60 mm diameter)
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What our Results Showed

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Long Beach

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Lung function higher means a higher of
children have reduced lung growth

?
Long Beach
get higher ?
Levels of

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6 of LB children have lower lung function than
normal
? ? ? ? ?
6
Long Beach
get higher ?
Levels of

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6 of LB children in our study have lower lung
function than normal ?
6
? ? ? ? ?
Long Beach
Only 2 of these children have reduced lung
function ?
2
get higher ?
Levels of

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? ? ? ? ?
Long Beach
6
2
get higher ?
Conclusion Children who live in communities
with higher levels of particulate matter are more
likely to have reduced lung function than
children who live in less polluted communities.
Children in LB 3x more likely than children in
less polluted communities like Lompoc, Santa
Maria, and Atascadero.
Levels of
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What our results show for elemental carbon
(diesel exhaust levels) and lung function in LB
X X
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Summary of Diesel and PM Levels in Long Beach

• The levels of Elemental Carbon as a marker for
  diesel exhaust are very high in Long Beach in
  fact, Long Beach has the highest levels in the 12
  communities we studied
• The levels of particulate matter in Long Beach
  are not the highest in the 12 communities we
  studied -- but they are 3X higher than levels in
  communities that have low pollution such as
  cleaner communities up the Coast

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Lung Function Summary

• A higher percentage of children living in more
  polluted communities, like Long Beach, are likely
  to have reduced lung function than children in
  less polluted communities.

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Why is lung function important?

• If at age 18 you have reduced lung function,
  there is a good chance you will always have
  reduced lung function
• Adult lung function is a good indicator of your
  future overall health and how long you will live

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Now lets look at the health effects of living
close to busy roads and freeways . . .
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First

• What do we know about air pollution levels near
  freeways?

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Air Quality is Worse Near a Freeway
(Zhu et al., 2002, 2006)
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How we studied traffic

• We looked at the addresses of children in our
  study to learn how far they lived from busy
  roads and freeways
• We divided children into groups
• Close
• Further away
• A lot further away

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What our results show

• Children living close to heavy traffic had
• Decreased lung function
• (Gauderman, 2007)
• Increased risk of asthma
• (Gauderman et al, 2005 McConnell et al., 2006)
• Increased
• respiratory symptoms
• (Kim et al., 2004 several European studies)

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First a reminder about the Metric System

• Meters
• One Meter

• About three feet

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Major Roads and Asthma more asthma if children
live within 150 meters (450 feet) of a major road
McConnell, et al, Environ Health Perspect
2006114766-772
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For Asthma

• Risk almost double in children living right next
  to a busy road
• Decreased to about the same as everyone else
  within about 4 blocks

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Freeways and Lung Function

• At age 18, children living lt500 meters vs. gt1,500
  meters from a freeway had
• 3 less than expected overall lung function
  
• 7 deficit (less than expected) in small
  airway function

500 meters about 1500 feet less than 1/3 of
a mile
Gauderman, W.J., et al.. Lancet, 2007. 369571-7
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What happens if someone with asthma lives in a
community with high particle levels?

• Children with asthma who live in high particle
  communities have more problems with bronchits
• (McConnell, et al. Environ Health Perspect 1999
  AJRCCM 2003 EHP 2006)

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Studies about other health effects from living
near freeways or busy roads
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• Heart disease, lung cancer and death
• INCREASED DEATH FROM HEART ATTACKS AND STROKE
  when levels of particle pollution rise
• (Pope CA, 3rd, Dockery DW. Health effects of fine
  particulate air pollution lines that connect. J
  Air Waste Manag Assoc 200656(6)709-42)
• THICKER ARTERIES in southern Californians living
  in areas with higher particle pollution
• (Kunzli N, Jerrett M, Mack WJ, et al. Ambient air
  pollution and atherosclerosis in Los Angeles.
  Environ Health Perspect 2005113(2)201-6)
• MORE LUNG CANCER in areas with more particle
  pollution and in workers exposed to diesel
  exhaust (Pope, et. Al. JAMA 2002287(9)1132-41

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Pregnant Women Living Near Freeway Traffic
Infants born between 1997-2000 in Los Angeles
County
Conclusion Mothers who lived close to freeway
traffic during pregnancy have more premature
low birth weight babies
Ritz et al, 2002. 2006
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Emerging ConcernsTraffic Related Pollutants

• Genetic susceptibility almost half of all
  children may have a genetic makeup that makes
  them more susceptible to allergic reactions from
  diesel exhaust exposure
• Ultrafine particles pass through the respiratory
  system into the body, including the brain
• Stroke?
• Alzheimers disease?
• Autism?
• Exposures at school?
• Commuting and other on-road exposures?

Gilliland, et. al. Lancet 2004363(9403)119-25
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Summary of Near Traffic Effects

• Studies in U.S. and in Europe show that
• LIVING NEAR BUSY ROADS AND FREEWAYS ESPECIALLY
  WITH LOTS OF TRUCK TRAFFIC -- IS LINKED TO
• Asthma
• Decreased lung function
• Heart disease
• Lung cancer
• Heart and lung effects and deaths
• Other emerging concerns
• There is strong health science justification for
  regulating exposures
• so that no one lives or goes to school or plays
  within 500 feet of roadways with heavy traffic