Ricardo Cisneros

A statistical model for determining impact of wildland fires on Particulate Matter (PM2.5) in Central California aided by satellite imagery of smoke

As the climate in California warms and wildfires become larger and more severe, satellite-based observational tools are frequently used for studying impact of those fires on air quality. However little objective work has been done to quantify the skill these satellite observations of smoke plumes have in predicting impacts to PM2.5 concentrations at ground level monitors, especially those monitors used to determine attainment values for air quality under the Clean Air Act. Using PM2.5 monitoring data from a suite of monitors throughout the Central California area, we found a significant, but weak relationship between satellite-observed smoke plumes and PM2.5 concentrations measured at the surface. However, when combined with an autoregressive statistical model that uses weather and seasonal factors to identify thresholds for flagging unusual events at these sites, we found that the presence of smoke plumes could reliably identify periods of wildfire influence with 95% accuracy.

Spatial and seasonal patterns of particulate matter less than 2.5 microns in the Sierra Nevada Mountains, California

This paper presents particulate matter data collected in the California southern Sierra Nevada Mountains (SNM) during 2002 to 2009 from the Central Valley (elevation 91 m) into the SNM (elevation 2 598 m). Annual average concentrations of particles smaller than 2.5 µm in diameter (PM2.5) for all sites during this study ranged from 3.1 to 22.2 µg m –3 . The

Latino and Non-Latino Perceptions of the Air Quality in California's San Joaquin Valley.

The San Joaquin Valley (SJV) of California has poor air quality, high rates of asthma, and high rates of obesity. Informational campaigns aimed at increasing awareness of the health impacts of poor air quality and promoting behavior change need to be tailored to the specific target audiences. The study examined perceptions of air quality, perceived health impacts, and methods of accessing information about air quality between Latinos and other groups in the SJV. Residents of the SJV (n = 744) where surveyed via one of three methods: community organizations (256), public locations (251), and an internet panel (237). The results suggest that people perceive the air quality in their region to be generally unhealthy, particularly for sensitive groups. The air quality is more likely to be reported as being unhealthy by people with health problems and less unhealthy by Latinos and people who report regularly exercising. Latinos are more likely to report working outdoors regularly, but also more likely to report being able to reduce their exposure if the air quality is unhealthy. The results report differences in informational sources about air quality, suggesting that informational campaigns should target high risk groups using a variety of media.

Ozone pollution and asthma emergency department visits in the Central Valley, California, USA, during June to September of 2015: a time-stratified case-crossover analysis

Abstract Objective: The San Joaquin Valley (SJV) exceeds the state and national standards for ozone (O3). This study investigates whether short-term exposure to O3 is associated with asthma emergency department (ED) visits. Methods: We identified 1,101 ED visits in June–September of 2015 in SJV, California, who lived within 15 km of active air monitors. Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with an interquartile (IQR) increase in ozone. We explored the potential effect modification by sex (female and male), race (White, Black and Hispanic), age (2–5, 6–18, 19–40, 41–64 and > = 65) and county (Merced, Madera, Kings, Fresno and Kern). Results: An IQR range (18.1 ppb) increase in O3 exposure three days before an asthma attack (lag 3) was associated with a 6.6% [OR: 1.066 (95% CI: 1.032, 1.082)] increase in the odds of having an asthma ED visit. The overall ORs differed across age groups and races/ethnicities, with strongest for children aged 6–18 years [OR: 1.219 (95% CI: 1.159, 1.280)], adults 19–40 years [OR: 1.102 (95% CI: 1.053, 1.154)] and Blacks [OR: 1.159 (95% CI: 1.088, 1.236)], respectively. O3 exposure was not positively associated with asthma ED visits for Whites, while it was for other underrepresented groups. Fresno had the highest number of asthma ED visits and positive association among all five counties. Conclusion: We found that O3 exposure is associated with asthma ED visits in the SJV.

Soda consumption and hospital admissions among Californian adults with asthma

ABSTRACT Introduction: Asthma prevalence has been increasing consistently since 1995 in California. Recent studies have found that consuming soda and sugar-containing drinks may pose a risk for asthma. Research that examines the relationship between soda intake and asthma among adult asthmatics is limited. Objective: This study investigated the relationship between sugar-sweetened soda consumption and asthma hospitalization among adult asthmatics in California. Methods: This cross-sectional study was based on the 2011–2012 California Health Interview Survey (CHIS) data and included 3,784 adults who were diagnosed with asthma by a doctor and who currently reported either that they still had asthma, or that they had suffered from an asthma attack in the last 12 months. The analysis was survey weighted. The exposure variable was soda intake measured as the number of times soda was consumed in the last week. The health outcome measure was overnight hospital admission due to asthma. Logistic regression was used to examine the association between soda consumption and overnight hospital admission after adjusting for age, education, sex, race/ethnicity, weight status, smoking status, and self-rated health. Results: Adults with asthma who drank soda three or more times per week reported higher odds of overnight hospitalization (adjusted odds ratio = 2.77, 95% CI: 1.51–5.10, p = 0.001). Conclusions: Our findings suggest that efforts designed to limit soda consumption would benefit asthma suffers by reducing hospital admissions. This, however, needs further research to confirm a direct causal association.

Health care access, concentrated poverty, and pediatric asthma hospital care use in California's San Joaquin Valley: A multilevel approach

ABSTRACT Background: Californias San Joaquin Valley is a region with a history of poverty, low health care access, and high rates of pediatric asthma. It is important to understand the potential barriers to care that challenge vulnerable populations. Objective: The objective was to describe pediatric asthma-related utilization patterns in the emergency department (ED) and hospital by insurance coverage as well as to identify contributing individual-level indicators (age, sex, race/ethnicity, and insurance coverage) and neighborhood-level indicators of health care access. Methods: This was a retrospective study based on secondary data from California hospital and ED records 2007–2012. Children who used services for asthma-related conditions, were aged 0–14 years, Hispanic or non-Hispanic white, and resided in the San Joaquin Valley were included in the analysis. Poisson multilevel modeling was used to control for individual- and neighborhood-level factors. Results: The effect of insurance coverage on asthma ED visits and hospitalizations was modified by the neighborhood-level percentage of concentrated poverty (RR = 1.01, 95% CI = 1.01–1.02; RR = 1.03, 95% CI = 1.02–1.04, respectively). The effect of insurance coverage on asthma hospitalizations was completely explained by the neighborhood-level percentage of concentrated poverty. Conclusions: Observed effects of insurance coverage on hospital care use were significantly modified by neighborhood-level measures of health care access and concentrated poverty. This suggests not only an overall greater risk for poor children on Medi-Cal, but also a greater vulnerability or response to neighborhood social factors such as socioeconomic status, community cohesiveness, crime, and racial/ethnic segregation.