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Spatial heterogeneity in the acute effects of ambient air pollution and temperature on pediatric seizures and epilepsy across New York
Abstract   Open access   Peer reviewed

Spatial heterogeneity in the acute effects of ambient air pollution and temperature on pediatric seizures and epilepsy across New York

Rachit Sharma, Lisa Frueh, Ellen K Joyce, Alan C Just, Aritra Halder, Perry E Sheffield and Jane E Clougherty
Environmental health perspectives. Supplements, v 2024(1)
15 Aug 2024
DOI: https://doi.org/10.1289/isee.2024.0940
url
https://doi.org/10.1289/isee.2024.0940View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

BACKGROUND AND AIM[|]Air pollution, temperature, and social stressors are linked to several neurological disorders, but research on association with seizures and epilepsy is scarce. We examined a) spatial heterogeneity in daily ambient fine particulate matter (PM_2.5) and minimum temperature (T_min) and pediatric seizures and epilepsy across New York State (NYS), and b) role of social stressors in explaining the heterogeneity.[¤]METHOD[|]Administrative data on seizure and epilepsy cases among children (aged 0-4 years; n = 300,870), presenting at NYS emergency departments (EDs) from 2005 to 2019 were obtained. Ensemble-modeled block-group level, daily PM_2.5 and T_min estimates were assigned to each case, along with 56 census-tract-level material deprivation indicators from the American Community Survey’s 5-year estimates. Additionally, nine tract-level, annual crime risk indices representing psychosocial stress were assigned to the 2015-2019 subset. Using conditional logistic regression in a case-crossover design, we quantified the season-specific effects of PM_2.5 and T_min on daily ED visits at state-, county-, and tract-levels. Employing a spatial Bayesian hierarchical model we then examined for any spatial heterogeneity in the effects, followed by assessing the role of social stressors in explaining the heterogeneity using random effects meta-regression.[¤]RESULTS[|]Warm-season PM_2.5 and cold-season T_min were positively associated with increased risk of ED visits, particularly at tract-level in New York, Bronx, Albany, and Erie counties. Statewide, spatial heterogeneity in ED visit rate differences was also observed across tracts and was associated with social stressors. For instance, in New York City, tracts with higher violent crime and felony assault rates, percent poverty, percent population not graduated from high school, and unemployment rates showed stronger PM_2.5 effects, after adjusting for T_min and specific humidity.[¤]CONCLUSIONS[|]Daily PM_2.5 and T_min may be associated with pediatric seizure and epilepsy risk in NYS, with spatial variations across counties and census-tracts potentially attributable to differences in social stressors increasing community vulnerability.[¤]

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