Background: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied. Objective: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults. Methods: A cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select small geographic areas denoted as 14-digit USGS hydrologic units (HUCs). Households were enumerated within selected HUCs. Community health workers collected in-person interviews. The proximity of nearby active and inactive coal mining operations, density of oil and gas operations, and density of roadways were characterized for all HUCs. Poisson regression analyses were used to estimate adjusted prevalence ratios. Results: From 1,459 eligible households contacted, 1,190 individuals were recruited, and 972 persons completed the interviews. The prevalence of lifetime asthma was 22.8%; current asthma was 16.3%. Adjusting for covariates, roadway density was positively associated with current asthma in the second (aPR = 1.61; 95% CI 1.04–2.48) and third tertiles (aPR = 2.00; 95% CI 1.32–3.03). Increased risk of current asthma was associated with residence in public, multi-unit housing (aPR = 2.01; 95% CI 1.27–3.18) compared to a residence in a single-family home. There were no notable associations between proximity to coal mining and oil and gas operations and asthma prevalence. Conclusions: This study suggests that residents in rural areas with higher roadway density and those residing in public housing units may be at increased risk for current asthma after accounting for other known risk factors. Confirming the role of traffic-related particulates in producing high asthma risk among adults in this study contributes to the understanding of the multiple environmental exposures that influence respiratory health in the Appalachia region.
|Journal||Environmental Health: A Global Access Science Source|
|State||Published - Dec 2023|
Bibliographical noteFunding Information:
The authors acknowledge the National Institute of Environmental Health Sciences for funding the current study under grant number 5 R01 ES024771-05.
We recognize the editorial and technical support of Steve Claas of the Office of Scientific Writing at the University of Kentucky. We gratefully acknowledge the leadership and contributions of Nell Fields of the Mountain Air Project staff and the contributions of the Mountain Air Project Community Advisory Board. We also acknowledge the tireless efforts of the community health workers including Darlene Warf, Betty Keith, Denise Baird, Libby Honeycutt, and Penny Lee who recruited participants and conducted surveys. Finally, we acknowledge the time and efforts of the participants in the Mountain Air Project in Harlan and Letcher counties and are grateful for their participation.
© 2023, The Author(s).
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health, Toxicology and Mutagenesis