Associations Between Emergency Room Visits for Respiratory Diseases and Exposure to Zip Code Level Criteria Air Pollutants in New York State

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Abstract
We assess associations between emergency room (ER) visits, scaled to per 105 population per year, for asthma and chronic obstructive pulmonary disease (COPD), two of the most common respiratory diseases, and zip-code level exposure to criteria air pollutants (CAPs) coming from point sources in New York State (NYS) from 2010 to 2018. Exposure data on point source CAPs was retrieved from the United States Environmental Protection Agency (USEPA) National Emission Inventory (NEI) database and ER visits for asthma and COPD were acquired from the New York State Department of Health (NYSDOH) Statewide Planning and Research Cooperative System (SPARCS). To account for within-county variability we used log-linear mixed effects models, adjusted for year, sex, age category, county level poverty, smoking, PM2.5, volatile organic compounds (VOCs) and CAPs sources within the study period. Results show significant associations between ER visits for asthma and COPD and most of the pollutants in the study, even after adjusting for the effects of poverty and smoking. The findings suggest that zip-code level point source criteria air pollutants, while comprising a small portion of total air pollution, poses a modest but significant contribution to the risk of respiratory disease-related ER visits.
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