Research Hub

Background
While air pollution has been associated with depression and anxiety in adults, its impact on childhood mental health is understudied.
Objective
We examined lifetime exposure to traffic-related air pollution (TRAP) and symptoms of depression and anxiety at age 12 years in the Cincinnati Childhood Allergy and Air Pollution Study cohort.
Methods
We estimated exposure to elemental carbon attributable to traffic (ECAT), a surrogate of diesel exhaust, at birth, age 12 years, and average exposure throughout childhood, using a validated land use regression model. We assessed depression and anxiety at age 12 years by parent report with the Behavior Assessment System for Children-2, and by child report with the Child Depression Inventory-2 (CDI-2) and the Spence Children's Anxiety Scale (SCAS). Associations between TRAP at birth, age 12 years, and childhood average and mental health outcomes were estimated using linear regression models adjusting for covariates including parent depression, secondhand smoke exposure, race, household income, and others.
Results
Exposure to ECAT was not significantly associated with parent-reported depression or anxiety. However, exposure to ECAT at birth was associated with increased child-reported depression and anxiety. Each 0.25 µg/m3 increase in ECAT was associated with a 3.5 point increase (95% CI 1.6–5.5) in CDI-2 scores and 2.3 point increase (95% CI 0.8–3.9) in SCAS total anxiety scores. We observed similar associations between average childhood ECAT exposures but not for concurrent exposures at age 12.
Conclusions
TRAP exposure during early life and across childhood was significantly associated with self-reported depression and anxiety symptoms in children. The negative impact of air pollution on mental health previously reported among adults may also be present during childhood.

Published Jun 1, 2019

Yolton, K., Khoury, J. C., Burkle, J., LeMasters, G., Cecil, K., & Ryan, P. (2019). lifetime exposure to traffic-related air pollution and symptoms of depression and anxiety at age 12 years. Environmental Research, 173, 199–206. https://doi.org/10.1016/J.ENVRES.2019.03.005

Diesel emissions from school buses expose children to high levels of air pollution; retrofitting bus engines can substantially reduce this exposure. Using variation from 2656 retrofits across Georgia, we estimate effects of emissions reductions on district-level health and academic achievement. We demonstrate positive effects on respiratory health, measured by a statewide test of aerobic capacity. Placebo tests on body mass index show no impact. We also find that retrofitting districts experience significant test score gains in English and smaller gains in math. Our results suggest that engine retrofits can have meaningful and cost-effective impacts on health and cognitive functioning.

Published Jun 1, 2019

Austin, W., Heutel, G., & Kreisman, D. (2019). School bus emissions, student health and academic performance. Economics of Education Review, 70, 109–126. https://doi.org/10.1016/J.ECONEDUREV.2019.03.002

Electric buses are poised to represent an increasingly larger share of the United States bus market due to the benefits of avoided air pollution, zero carbon emissions, and lower operation & maintenance costs. However, while total cost of ownership is approaching parity for electric buses versus diesel buses (and in some cases, even undercutting diesel), transit agencies and municipalities face the common problem of higher upfront capital expenditures required for electric buses versus traditional diesel-powered alternatives. This study examines the current mechanisms by which public transit agencies have procured electric buses to date as well as new, innovative financing models, with a focus on four states that have been highly active in this space: California, South Carolina, Texas, and Washington.

Published Apr 26, 2019

Liu, D., Mba ’19 Advisor, M. /, & Buley, J. (2019). The U.S. Electric Bus Transition: An Analysis of Funding and Financing Mechanisms. https://dukespace.lib.duke.edu/dspace/bitstream/handle/10161/18464/The U.S. Electric Bus Transition - An Analysis of Funding and Financing Mechanisms.pdf?sequence=1

Children living in lower-income urban communities are at much greater risk of developing asthma, going to the emergency department for an asthma attack and being hospitalized for asthma than children living in upper- and middle-income communities. For many asthmatic children living in urban communities, especially those with greater morbidity, the allergic pathway is important in the etiology of the disease. The stages of developing allergic disease can be divided into the onset of allergic sensitization, development of allergic disease and subsequent exacerbations, and it is useful to consider the relevance of interventions at each of these stages. Indoor allergens and environmental exposures are a major contributor to allergic disease, particularly among lower socioeconomic status, urban, minority communities. These exposures include allergens, environmental tobacco smoke, combustion by-products, and mold, all of which can play an important role in asthma progression as well as morbidity. These exposures are often not found in isolation and thus these concomitant exposures need to be considered when conducting environmental interventions. There have been numerous studies looking at both primary and tertiary prevention strategies and the impact on allergic sensitization and asthma with varied results. While the outcomes of these studies have been mixed, what has emerged is the need for tertiary interventions to be targeted to the individual and to reduce all relevant exposures to which an asthmatic child is exposed and sensitized. In addition, effective intervention strategies must also consider other social determinants of asthma morbidity impacting low socioeconomic, urban communities.

Published Mar 22, 2019

Conrad, L., & Perzanowski, M. S. (2019). The Role of Environmental Controls in Managing Asthma in Lower-Income Urban Communities. In Clinical Reviews in Allergy and Immunology (Vol. 57, Issue 3, pp. 391–402). Humana Press Inc. https://doi.org/10.1007/s12016-019-08727-y

Fine particulate matter (PM2.5) air pollution exposure is the largest environmental health risk factor in the United States. Here, we link PM2.5 exposure to the human activities responsible for PM2.5 pollution. We use these results to explore “pollution inequity”: the difference between the environmental health damage caused by a racial–ethnic group and the damage that group experiences. We show that, in the United States, PM2.5 exposure is disproportionately caused by consumption of goods and services mainly by the non-Hispanic white majority, but disproportionately inhaled by black and Hispanic minorities. On average, non-Hispanic whites experience a “pollution advantage”: They experience ∼17% less air pollution exposure than is caused by their consumption. Blacks and Hispanics on average bear a “pollution burden” of 56% and 63% excess exposure, respectively, relative to the exposure caused by their consumption. The total disparity is caused as much by how much people consume as by how much pollution they breathe. Differences in the types of goods and services consumed by each group are less important. PM2.5 exposures declined ∼50% during 2002–2015 for all three racial–ethnic groups, but pollution inequity has remained high.

Published Mar 11, 2019

Tessum, C. W., Apte, J. S., Goodkind, A. L., Muller, N. Z., Mullins, K. A., Paolella, D. A., . . . Hill, J. D. (2019). Inequity in consumption of goods and services adds to racial–ethnic disparities in air pollution exposure. Proceedings of the National Academy of Sciences, 116(13), 6001-6006. doi:10.1073/pnas.1818859116

Air pollution is a worldwide environmental health issue. Increasingly, reports suggest that poor air quality may be associated with mental health problems, but these studies often use global measures and rarely focus on early development when psychopathology commonly emerges. To address this, we combined high-resolution air pollution exposure estimates and prospectively-collected phenotypic data to explore concurrent and longitudinal associations between air pollutants of major concern in urban areas and mental health problems in childhood and adolescence. Exploratory analyses were conducted on 284 London-based children from the Environmental Risk (E-Risk) Longitudinal Twin Study. Exposure to annualized PM2.5 and NO2 concentrations was estimated at address-level when children were aged 12. Symptoms of anxiety, depression, conduct disorder, and attention-deficit hyperactivity disorder were assessed at ages 12 and 18. Psychiatric diagnoses were ascertained from interviews with the participants at age 18. We found no associations between age-12 pollution exposure and concurrent mental health problems. However, age-12 pollution estimates were significantly associated with increased odds of major depressive disorder at age 18, even after controlling for common risk factors. This study demonstrates the potential utility of incorporating high-resolution pollution estimates into large epidemiological cohorts to robustly investigate associations between air pollution and youth mental health.

Published Feb 1, 2019

Roberts, S., Arseneault, L., Barratt, B., Beevers, S., Danese, A., Odgers, C. L., Moffitt, T. E., Reuben, A., Kelly, F. J., & Fisher, H. L. (2019). Exploration of NO2 and PM2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study. Psychiatry Research, 272, 8. https://doi.org/10.1016/J.PSYCHRES.2018.12.050

Climate change is already adversely affecting human health and health systems, 1,2 and projected climate change is expected to alter the geographic range and burden of a variety of climate-sensitive health outcomes and to affect the functioning of public health and health care systems. If no additional actions are taken, then over the coming decades, substantial increases in morbidity and mortality are expected in association with a range of health outcomes, including heat-related illnesses, illnesses caused by poor air quality, undernutrition from reduced food quality and security, and selected vectorborne diseases in some locations; at the same time, worker productivity is expected to decrease, particularly at low latitudes. 3,4 Vulnerable populations and regions will be differentially affected, with expected increases in poverty and inequities as a consequence of climate change. Investments in and policies to promote proactive and effective adaptation and reductions in greenhouse-gas emissions (mitigation) would decrease the magnitude and pattern of health risks, particularly in the medium-to-long term.

Published Jan 1, 2019

Haines, A., & Ebi, K. (2019). The imperative for climate action to protect health. New England Journal of Medicine, 380(3), 263–273. https://doi.org/10.1056/NEJMra1807873

Considerations for electrifying school buses are presented with an analysis of battery sizing to match bus-driving requirements. The charging and vehicle-to-building dispatch of the electric school buses were optimized to evaluate the potential to reduce the impact of the bus charging on the school's electric utility bill. Distributed energy resources and flexible building loads were also considered with the school bus electrification to evaluate the further reductions in energy costs with enhanced systems integration and optimized dispatch. The effect of degradation on the school bus batteries was analyzed to determine if the smart-charging and vehicle-to-building battery operation decreases the life of the battery. The results show that there is an opportunity to mitigate the increase in electric utility bill with improved charging controls and bi-directionally operating the school bus batteries. The battery degradation analysis using dispatch with optimized charging and discharging shows that acceptable battery life remains.

Published Jan 1, 2019

Becker, W., Miller, E., Mishra, P. P., Jain, R., Olis, D., & Li, X. (2019, October 1). Cost Reduction of School Bus Fleet Electrification with Optimized Charging and Distributed Energy Resources. 51st North American Power Symposium, NAPS 2019. https://doi.org/10.1109/NAPS46351.2019.9000330

The effect of acute and long-term exposures to outdoor particulate air pollution on lung function in healthy adults is not well established. The objective of this study was to conduct a systematic literature review and meta-analysis of studies that assessed the relationship of outdoor particulate air pollution and lung function in healthy adults. Studies that contained data on outdoor air particulate matter levels (PM 10 or PM 2.5) and forced expiratory volume in 1 s (FEV 1) in healthy adults were eligible for inclusion. Effect estimates, in relation to long-term and acute exposures, were quantified separately using random effects models. A total of 27 effect estimates from 23 studies were included in this review. Acute exposures were typically assessed with PM 2.5, while long-term exposures were predominantly represented by PM 10. A 10 μg/m3 increase in short-term PM 2.5 exposure (days) was associated with a -7.02 mL (95% CI -11.75 to -2.29) change in FEV 1. A 10 μg/m 3 difference in long-term PM 10 exposure was associated with a -8.72 mL (95% CI -15.39 to -2.07) annual change in FEV 1 and an absolute difference in FEV 1 of -71.36 mL (95% CI -134.47 to -8.24). This study provides evidence that acute and long-term exposure to outdoor particulate air pollution are associated with decreased FEV 1 in healthy adults. Residual confounding from other risk factors, such as smoking, may explain some of the effect for long-term exposures. More studies are required to determine the relationship of long-term exposure to PM 2.5 and short-term exposure to PM 10, which may have different biologic mechanisms.

Published Jan 1, 2019

Edginton, S., O’sullivan, D. E., King, W., & Lougheed, M. D. (2019). Effect of outdoor particulate air pollution on FEV 1 in healthy adults: a systematic review and meta-analysis. Occupational and Environmental Medicine, 76(8), 583–591. https://doi.org/10.1136/oemed-2018-105420

We examine the effect of school traffic pollution on student outcomes by leveraging variation in wind patterns for schools the same distance from major highways. We compare within-student achievement for students transitioning between schools near highways, where one school has had greater levels of pollution because it is downwind of a highway. Students who move from an elementary/middle school that feeds into a “downwind” middle/high school in the same zip code experience decreases in test scores, more behavioral incidents, and more absences, relative to when they transition to an upwind school. Even within zip codes, microclimates can contribute to inequality.

Published Jan 1, 2019

Heissel, J., Persico, C., & Simon, D. (2019). Does pollution drive achievement? The effect of traffic pollution on academic performance. doi:10.3386/w25489