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Impact of NOx emissions reduction policy on hospitalizations for respiratory disease in New York State

Journal of Exposure Science & Environmental Epidemiology volume 23, pages 73–80 (2013)Cite this article

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Abstract

To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agency's (EPA) nitrogen oxides (NOx) Budget Trading Program (NBP), on respiratory health in New York State (NYS). Time-series analysis using generalized additive models was applied to assess changes in daily hospitalizations for respiratory diseases in NYS after the implementation of the NBP policy. Respiratory end points in the summers during the baseline period (1997–2000) were compared with those during the post-intervention period (2004–2006). Stratified analyses were also conducted to examine whether health impacts of the NBP differed by socio-demographic, regional, or clinical characteristics. Following the implementation of EPA's NBP policy, there were significant reductions in mean ozone levels (−2% to −9%) throughout NYS. After adjusting for time-varying variables, PM2.5 concentration, and meteorological factors, significant post-intervention declines in respiratory admissions were observed in the Central (−10.18, 95% confidence interval (CI): −14.18, −6.01), Lower Hudson (−11.05, 95% CI: −16.54, −5.19), and New York City Metro regions (−5.71, 95% CI: −7.39, −4.00), consistent with wind trajectory patterns. Stratified analyses suggest that admissions for asthma, chronic airway obstruction, among those 5–17 years old, self-payers, Medicaid-covered, and rural residents declined the most post-NBP. This study suggests that the NOx control policy may have had a positive impact on both air pollution levels statewide and respiratory health in some NYS regions. However, the effect varied by disease subgroups, region, and socio-demographic characteristics.

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Authors and Affiliations

  1. New York State Department of Health, Center for Environmental Health, 547 River Street, Room 200, Troy, New York 12180, USA,

    Shao Lin, Rena Jones, Cristian Pantea & Syni-An Hwang

  2. National Exposure Research Laboratory, US Environmental Protection Agency, Research Triangle Park, 27711, North Carolina, USA

    Halûk Özkaynak, S Trivikrama Rao & Valerie C Garcia

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  1. Shao Lin
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  2. Rena Jones
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Correspondence to Shao Lin.

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The United States Environmental Protection Agency through its Office of Research and Development collaborated in the research described hereunder. It has been subjected to Agency review and approved for publication.

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Lin, S., Jones, R., Pantea, C. et al. Impact of NOx emissions reduction policy on hospitalizations for respiratory disease in New York State. J Expo Sci Environ Epidemiol 23, 73–80 (2013). https://doi.org/10.1038/jes.2012.69

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