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The Association between Ambient Air Quality Ozone Levels and Medical Visits for Asthma in San Juan County August 2007

The New Mexico Department of Health (NMDOH) Environmental Health Tracking Project has been compiling and analyzing data on air quality and respiratory health of New Mexicans. While other studies in the United States have shown an association between the frequency of asthma attacks and ground level ozone in large urban areas, few researchers have focused on largely rural communities in the desert southwest. To perform the analysis, the daily number of asthma-related emergency room visits to emergency departments for 2000 to 2003 were matched to daily ozone levels during April – September. The ozone concentration data were obtained from nationwide datasets compiled by the Environmental Protection Agency, but were collected by the NM Environment Department Air Quality Bureau. The study focused on ground level ozone during April to September because ground level ozone accumulates when warmer and longer days cause nitrogen oxides and volatile organic compounds in the air to react and generate ozone. These reactions can cause ozone concentrations to increase by more than 20 parts per billion (ppb) from one day to the next. The analysis used a statistical model to predict the effect that these changes in ozone concentrations have on the number of asthma-related emergency room visits. Two health outcomes were considered: daily presence or absence of an asthma-related medical visit and the number of visits. Ozone was associated with asthma-related medical visits. The distribution of ozone concentrations was similar to that observed in many large cities. Increased ozone (lagged two days) was associated with increased odds of at least one asthma-related medical visit by 42 %. The study found that when ozone increased by 20 ppb the number of emergency room visits increased by about 34%. While this is a small increase in the number of visits, sensitive persons may want to monitor air quality index forecasts to help limit their exposure to ozone. Ozone concentrations typically are highest in the early afternoon, so sensitive individuals should try to reduce their outdoor activities during this part of the day.