1. MODELING OF REGIONAL CLIMATE CHANGE EFFECTS ON GROUND-LEVEL OZONE AND CHILDHOOD ASTHMA Perry E. Sheffield, Kim Knowlton, Jessie L. Carr, Patrick L. Kinney

2. Background  Asthma  “is a genetic and environmental disorder” (1)  the most prevalent chronic disease among children  Morbidity  the occurrence of a disease among a population  Adolescent asthma morbidity is greatest among children in urban areas.  Ozone  a pollutant created by photochemical reactions with other pollutants and volatile organic chemicals (VOC)

3. Significance “canary in the coal mine” Image source: http://ithinkmining.com/2008/04/04/do-not-entrust-your-life-to-mining-professors-rely-on-your-own-judgement/

4. Methods  36 x 36 km grid covering NYC metropolitan area  14 counties  Models for global climate, regional climate, and regional air quality were coupled together  regional model: simulated ground-level ozone levels for June to August  health outcome model: 8 hour maximum ground-level ozone concentrations

5. Methods  summer county-level impacts measured by M = (P/10,000) x B x ERC M : average daily number of asthma emergency department visits of children ages 0-17 P : county population of 0-17 year olds B : basic county rate for daily asthma emergency visits during the summer of children ages 0-17, per 10,000 population ERC : exposure-risk coefficient of asthma morbidity

6. Method Problems  The ERC used was not geographically, diagnostically, or age specific to the population under study because there is no such information yet.  Population was kept constant in the 2020s.  Available data from the NYS Department of Health provided asthma emergency department visits of patients of any age.

7. Method Problems  Other factors on future morbidity rates were not analyzed, such as disease management, access to care, and demographic shifts.  Anthropogenic ground-level ozone emissions were kept constant, as well.

8. Results  For the Health Outcomes Assessment model, the average daily summer concentration for ground- level ozone increased across the measured grid by 2.7 to 5.3 ppb.  In the 2020s, the average regional adolescent asthma emergency department visits increased by 7.3%.  Projected population growth resulted in an average of a 10.6% increase in asthma morbidity.

9. Discussion Climate change could cause an increase of 7.3% in summer ozone related asthma emergency department visits among children aged 0 to 17 across New York City by the 2020s. Table source: page 254 of the paper

10. Additional Notes  The ozone simulations utilized did not account for outside climate influences.  the influence of air conditioning  This study provides a basis for local, regional, and national discussion of the effects of ground-level ozone on childhood asthma.

11. Source  Sheffield, P.E., K. Knowlton, J.L. Carr, P.L. Kinney. 2011. Modeling of regional climate change effects on ground-level ozone and childhood asthma. American Journal of Preventive Medicine 41:251-257.