ArticleEnvironmental health : a global access science source2015
Associations between ambient air pollutant mixtures and pediatric asthma emergency department visits in three cities: a classification and regression tree approach.
Article in Environmental health : a global access science source, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Mixture analysis identifies ozone as driving factor for child asthma symptoms.The journal of allergy and clinical immunology. Global · 2025Article
- Warm season ambient ozone and children's health in the USA.International journal of epidemiology · 2024Article
- Acute Effects of Ambient Air Pollution on Asthma Emergency Department Visits in Ten U.S. States.Environmental health perspectives · 2023Article
- Synergistic or Antagonistic Health Effects of Long- and Short-Term Exposure to Ambient NOInternational journal of environmental research and public health · 2022Review
- Joint association between ambient air pollutant mixture and pediatric asthma exacerbations.Environmental epidemiology (Philadelphia, Pa.) · 2022Article
- PMPediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2022Article
- Robust empirical Bayes approach for Markov chain modeling of air pollution index.Journal of environmental health science & engineering · 2021Article
- Model choice for estimating the association between exposure to chemical mixtures and health outcomes: A simulation study.PloS one · 2021Article
- Article
- The Respiratory Risks of Ambient/Outdoor Air Pollution.Clinics in chest medicine · 2020Review
- A Bayesian ensemble approach to combine PMEnvironmental research · 2019Article
- Triggering of cardiovascular hospital admissions by source specific fine particle concentrations in urban centers of New York State.Environment international · 2019Article
- Associations between multipollutant day types and select cardiorespiratory outcomes in Columbia, South Carolina, 2002 to 2013.Environmental epidemiology (Philadelphia, Pa.) · 2018Article
- Ambient air pollution and emergency department visits for asthma in Erie County, New York 2007-2012.International archives of occupational and environmental health · 2018Article
- Current approaches used in epidemiologic studies to examine short-term multipollutant air pollution exposures.Annals of epidemiology · 2017Review
- Prognostic factors analysis in EGFR mutation-positive non-small cell lung cancer with brain metastases treated with whole brain-radiotherapy and EGFR-tyrosine kinase inhibitors.Oncology letters · 2016Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCharacterizing multipollutant health effects is challenging. We use classification and regression trees to identify multipollutant joint effects associated with pediatric asthma exacerbations and compare these results with those from a multipollutant regression model with continuous joint effects.
methodsWe investigate the joint effects of ozone, NO2 and PM2.5 on emergency department visits for pediatric asthma in Atlanta (1999-2009), Dallas (2006-2009) and St. Louis (2001-2007). Daily concentrations of each pollutant were categorized into four levels, resulting in 64 different combinations or "Day-Types" that can occur. Days when all pollutants were in the lowest level were withheld as the reference group. Separate regression trees were grown for each city, with partitioning based on Day-Type in a model with control for confounding. Day-Types that appeared together in the same terminal node in all three trees were considered to be mixtures of potential interest and were included as indicator variables in a three-city Poisson generalized linear model with confounding control and rate ratios calculated relative to the reference group. For comparison, we estimated analogous joint effects from a multipollutant Poisson model that included terms for each pollutant, with concentrations modeled continuously. RESULTS AND DISCUSSION: No single mixture emerged as the most harmful. Instead, the rate ratios for the mixtures suggest that all three pollutants drive the health association, and that the rate plateaus in the mixtures with the highest concentrations. In contrast, the results from the comparison model are dominated by an association with ozone and suggest that the rate increases with concentration.
conclusionThe use of classification and regression trees to identify joint effects may lead to different conclusions than multipollutant models with continuous joint effects and may serve as a complementary approach for understanding health effects of multipollutant mixtures.
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