EPA-600/1-77-002
January 1977
LUNG FUNCTION IN SCHOOL CHILDREN:
1971-1972 CHATTANOOGA STUDY
By
Victor Hasselblad
Statistics and Data Management Office
Health Effects Research Laboratory
Research Triangle Park, N.C. 27711
U.S. ENVIRONMENTAL PROTECTION AGENCY
OFFICE OF RESEARCH AND DEVELOPMENT
HEALTH EFFECTS RESEARCH LABORATORY
RESEARCH TRIANGLE PARK, N.C. 27711
PROTECTION
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DISCLAIMER
This report has been reviewed by the Health Effects Research Laboratory,
U.S. Environmental Protection Agency, and approved for publication. Mention
of trade names or commercial products does not constitute endorsement or
recommendation for use.
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FOREWORD
The many benefits of our modern, developing, industrial society are
accompanied by certain hazards. Careful assessment of the relative risk
of existing and new man-made environmental hazards is necessary for the
establishment of sound regulatory policy. These regulations serve to
enhance the quality of our environment in order to promote the public
health and welfare and the productive capacity of our Nation's population.
The Health Effects Research Laboratory, Research Triangle Park
conducts a coordinated environmental health research program in toxicology,
epidemiology, and clinical studies using human volunteer subjects. These
studies address problems in air pollution, non-ionizing radiation,
environmental carcinogenesis and the toxicology of pesticides as well as
other chemical pollutants. The Laboratory develops and revises air quality
criteria documents on pollutants for which national ambient air quality
standards exist or are proposed, provides the data for registration of new
pesticides or proposed suspension of those already in use, conducts research
on hazardous and toxic materials, and is preparing the health basis for
non-ionizing radiation standards. Direct support to the regulatory function
of the Agency is provided in the form of expert testimony and preparation of
affidavits as well as expert advice to the Administrator to assure the
adequacy of health care and surveillance of persons having suffered imminent
and substantial endangerment of their health.
This particular epidemiologic study was conducted as part of the
Community Health Environmental Surveillance System (CHESS). Lung function
was used as the health indicator because previous studies suggested that
this measure is sensitive to air pollution. Chattanooga was chosen because
of its unique high ambient N02 air pollution exposures.
H. Knelson, M.D.
Erector,
Health Effects Research Laboratory
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ABSTRACT
Previous studies of lung function in children have indicated that decreases
in lung function are associated with higher air pollution exposures. For this
reason, three quarter second timed forced expiratory volume was chosen as one
of the health indicators in the Environmental Protection Agency's Community
Health Environmental Surveillance System (CHESS). The city of Chattanooga,
Tennessee was chosen because of its exposure to a large stationary source of
nitrogen dioxide. The present study, conducted in 1971-1972, was a follow-up
to an earlier study performed by Shy, et al. in 1968-1969. The present study
did not confirm the slight differences found in the earlier study. This might
be explained by the reduction in N02 levels since the 1968-1969 study.
iv
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ACKNOWLEDGMENTS
Several people contributed to the preparation of this report with little
or no credit. Listed alphabetically, they are, Robert Chapman, Barbara
Crabtree, John Creason, Wayne Fulford, Warren Galke, Jerome Gerding, Margarita
Morrison, Ken Mullins, William Nelson, Everett Quesnell, Michael Ouigley,
Carl Shy, and Jose Sune".
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INTRODUCTION
Significant decreases in lung function early in life may be a risk factor
for later respiratory disorders. Previous studies in Japan, Great Britain,
Italy and North America report decreased lung function in children living in
areas of high air pollution.1"5 Based on these findings, lung function in
school children measured by three-quarter second forced expiratory volume
(FEVg.ys) was selected as a health indicator in the Environmental Protection
Agency's Community Health Environmental Surveillance System (CHESS). Highly
significant decreases in lung function have been noted with aging, chronic
obstructive lung disease, and cigarette smoking.7 Ceasing cigarette smoking
lessens chronic respiratory disease symptoms.8 Therefore, reducing ambient
air pollution might improve lung function, and decrease risk of chronic
respiratory disease from previous elevated air pollution exposures.
The present study primarily investigates the effects on a community exposed
to a large stationary source of atmospheric nitrogen dioxide (N02). The source,
the Volunteer Army Ammunition Plant, is located in Hamilton County, Tennessee,
just beyond the northeastern fringes of the city of Chattanooga. A substantial
proportion of trinitrotoluene (TNT) produced in the United States was
manufactured at this plant, which operated only during World War II and the
Korean and Vietnam conflicts. Shy, et al,9 conducted a similar lung function
survey in Chattanooga in 1968-1969. Since that time, however, air quality in
the plant vicinity has improved due to pollution control and decreased TNT
production. This study, a follow-up of the 1968-69 survey, was designed to
test the hypothesis that early childhood exposure to ambient N02 air pollution
reduces lung function in later childhood. A similar lung function study of
New York City children exposed to increased sulfur oxide and particulate air
pollution in early childhood suggests that effects are still observed in
later childhood, although current pollution levels had been greatly reduced.10
Rejection of the above hypothesis would indicate that reduction in ambient
N02 air pollution may lead to improvements in lung function.
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METHODS
FEV Measurements and Covariates
Three geographic areas (or communities) each containing three elementary
schools were selected from Hamilton County, Tennessee: (1) Red Bank, a
control area three to five miles north of downtown Chattanooga, representing
low exposure to N02; (2) Brainerd, a low to intermediate exposure area east
of downtown Chattanooga; and (3) Harrison, the area nearest the plant, with
previous high exposure to N02. These areas are shown in Figure 1. Within
each community, children in the elementary schools were enrolled for the study.
Most children resided within one and one-half miles of at least one centrally
located air monitoring station. The three communities are geographically
close enough to experience similar meteorologic conditions so explicit
adjustment for differences in meteorology was not necessary. A total of 5589
children participated in the study. Each child's age, race, and sex were
obtained from school records. The analyses however, were restricted to
whites, since ethnic differences could have biased the study. In particular,
blacks have been shown to have lower measured lung function than whites of
comparable age, sex and height.11"14 Of the 4880 white children, 150 reporting
asthma during the study were deleted. Children with insufficient or no age
and sex information were also deleted, leaving 4704 children in the basic
analysis file. Deletions are detailed in Table 1. Age distributions by sex
and community are shown in Table 2 for children in the basic analysis file.
A family health questionnaire distributed in January, 1971 to the parents
of the study's children obtained information on smoking habits, educational
level of the parents, and length of residence. This questionnaire was the
same type described in Health Consequences of Sulfur Oxides: A Report from
CHESS 1970-1971.15 Information is summarized in Tables 3 and 4 for families
in the basic analysis file who returned the questionnaire. There was no
indication of educational differences by community. The fathers showed slight
smoking differences by community, but the differences showed no pattern. The
mothers had similar smoking habits across all three communities. Though the
smoking habits of elementary school children were not documented, there was
no particular reason to suspect that their smoking habits would be very
different in the high and low pollution areas. The prevalence of cigarette
smoking among children is probably most strongly influenced by parental
smoking habits and these were shown to be relatively similar. Table 5 shows
the length of residence in Chattanooga for all 3 communities. Although
there were differences by community, a majority of the families in each
community had lived in the city for 12 or more years. Eighty percent of the
families had lived in the city for at least four years, which includes the
periods of elevated exposures. Thus the effects of migration should be
minimized in this study.
The three-quarter second forced expiratory volume (FEVo.ys) test was
performed in the schools. Two rounds of testing were conducted: in winter
(February-March 1972) and in spring (April-May 1972). Just before testing,
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children received an introduction and test demonstration, which emphasized
maximal inspiration first, then expiration, as forceful and complete as
possible, into the spirometer. Each child was tested until three valid FEV
measurements were obtained. Since the FEV0>75 is effort dependent, the
maximum of each child's three readings was used in data analysis. At the time
of testing, each child also reported the presence or absence of a cough, cold,
sore throat, or asthma.
All tests were performed with a 12-liter bellows-type spirometer
manufactured by Cardiopulmonary Instruments, Inc. (CPI). In this instrument,
expired air displaces a cylinder whose air seal is a pliable rolling diaphragm.
The mechanical displacement of a piston over 0.75 second is transduced to a
voltage which is displayed, as FEV0-75, on a nixie-tube digital readout. The
CPI instrument was calibrated before testing against both a Collins water-
fined spirometer and 1.5 liter syringe. Several times each testing day,
the linearity of the digital readout was checked. All raw FEV0-75 readings
from the CPI instruments were converted to body temperature and pressure,
aturated conditions (BTPS).
c
The 4704 elementary school children included in the basic analysis file
were analyzed separately by age, sex, and season. An age cut was made at 9
years (108 months) because the relative effects of age and height on lung
function appear to change near this age.10 Each analysis required deletions for
inadequate information, summarized in Table 1. The FEV's were required to be
between 0.4 and 4.0 liters. The heights were restricted to a range from 30 to
72 inches. If any of the variables were missing, or outside the indicated
ranges, that observation was deleted from the analysis.
The statistical analyses were made using a general linear model.16 The
particular model which was chosen allowed for a linear effect of standing
height and age, as well as for community and machine differences. A
dichotomous variable was also included to indicate a cough, cold or sore throat.
The tests of significance can be thought of as a test of the effect of a
particular variable above and beyond the effect of all other variables. This
procedure can be conservative, if the independent variables are highly correlated
In this case, the factors of age, height and machine are independent of
community and symptom, and so the tests for community differences or symptom
effect should not suffer from this problem. The means shown in the analysis
tables (Tables 15 and 17) are adjusted for age and height differences.
Pol 1utant Exposures
Air pollution exposures were constructed with data from five sources:
(1) local monitoring done at the 9th street and Georgia Avenue post office,
(2) averages from two stations at the Volunteer Army Ammunition Plant (VAAP),
(3) Division of Abatement, National Air Pollution Control Administration
(NAPCA), data used for an interstate air quality study,17 (4) Division of
Health Effects NAPCA, data used in the study by Shy, et al,10 and (5) the
CHESS network, which was installed for this and other related studies.
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The 9th street post office and the VAAP data provide the only year to
year comparisons of pollution levels prior to 1970. The 9th street post office
data were collected using a high-volume sampler. Data from 1958 to 1972 for
TSP, Nitrate, and Sulfate are shown in Table 6. The VAAP data consists of
N02 measurements collected using a Technicon instrument with a Saltzman
reagent. Data from two sites for the years 1968-1973 are shown in Table 7.
The N02 data collected by the Division of Abatement, NAPCA, were used
for an interstate air quality study of Chattanooga, Tennessee and Rossville,
Georgia.17 The data were collected from September, 1967 to November 1968 at
10 sites. The sites are shown in Figure 2, and the data are shown in Table
8. The colorimetric Saltzman technique was used at all stations.
The data collected by the Division of Health Effects, NAPCA, are taken from
the study by Shy, et al.10 The data are shown in Table 9, with the N02 data
converted to yg/m3. The locations of the monitoring sites are shown in Figure
1. The N02 data were measured by the Jacobs-Hochheiser method, so the
accuracy of the values is very questionable. This method has interference
problems summarized in a paper by Mauser and Shy.18 Both the N02 and nitrate
values do show much higher levels in the Harrison area, and such differences
could not likely be entirely due to the measurement method.
CHESS data were available for four pollutants: total suspended
particulates (TSP), sulfate fraction of the TSP (sulfate), nitrate fraction
of the TSP (nitrate), and nitrogen dioxide (N02). All of the pollutants
were measured in micrograms per cubic meter (pg/m3). The measurements for
TSP, sulfate, and nitrate all came from a hi-volume air sampler. The methods
are detailed in Appendix A of Health Consequences of Sulfur Oxides: A Report
from CHESS, 1970-1971.16 The N02 data were measured by the Jacobs-Hochheiser
procedure. These data are presented only to give a rough estimate of the
relative exposures during the years 1970 to 1972. The CHESS aerometric data
are presented in Tables 10-13. Table 14 gives a summary by year. There were
two sites in Red Bank, two in Brainerd, and five in the Harrison community.
The locations of the sites are shown in Figure 1.
Although there is much site-to-site and year-to-year variation, some
general conclusions about the areas can be drawn: 1) TSP levels have been
quite similar across all areas; the levels in Harrison were slightly lower if
there were any differences, 2) Sulfate fractions were very similar across
all areas, 3) Nitrate levels have been highest in Harrison, and lowest in
Red Bank, 4) N02 values were higher primarily at site 31 in Harrison, but
sites nearer the Volunteer Army Ammunition Plant showing higher values than
those farther away, and 5) both N02 and nitrate levels were higher around
1968-1969 in all areas, and have decreased since then.
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RESULTS
The adjusted mean FEV's for each community appear in Table 15. These
FEV's are adjusted for height, age, machine, and presence of symptoms. They
are computed for each age-sex category by season. Where possible, each
student's winter and spring readings were averaged and the analyses of these
averages also appear in Table 15.
The adjusted means (Table 15) show generally lower values in the
Harrison area during the winter season, but higher values in the spring
season. There are almost no differences in the adjusted means for the
average of the two seasons. None of the differences were significant at the
.05 level for the winter season (Table 16). All significant inter-community
differences showed Harrison with higher mean values.
One by-product of the analysis is a table of the effect of a cold, cough,
or sore throat has on children's FEV. These average effects, adjusted for age.
height, machine, and community are shown in Table 17. In all but one
analysis (females less than 108 months, spring season), the adjusted mean
values for children with symptoms were less than those without symptoms.
These differences were significant at the .05 level in only 2 of the 7
analyses, however. The differences averaged about 20 cubic centimeters.
Regression coefficients, mean heights and ages, and mean square errors
are given in Tables 18, 19, and 20. These values are presented for
comparison with other studies. The regression coefficients verify the
finding that the FEV's of younger children are more dependent on age than
the FEV's of the older children. The tables can also be used to generate
confidence intervals about the adjustment equations. Younger children,
who have smaller lung capacities, showed an expected smaller mean square
error. The averages of the two seasons also showed a smaller mean square
error than either of the separate seasons, which is consistent with the
properties of the variance of an average.
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CONCLUSIONS
The hypothesis was not supported that previous or current elevated NO?
or nitrate exposures have an irreversible neasureable effect on children's
ventilatory performance. The only adjusted mean FEV's for the Harrison
community that were lower than the other communities occurred in the winter
season, and none of these were statistically significant. The means in the
Harrison community for the spring season were generally higher than the other
two communities, and the averages for the two seasons were quite similar for
all three communities. There is nothing in the aerometric data to suggest
that the Harrison community had a unique higher exposure during the winter
season only.
The lack of consistent differences attributable to pollution in this
study does not contradict the earlier study of Shy, et al.9 The Shy study
found a slight effect attributable to N02 pollution, but was done during a
period of greatly elevated exposures, as indicated by the aerometric data.
The present study was conducted at least two years after these elevated
exposures. The effects on lung function may be at least partially reversible.
There is always the possibility that machine or technician biases masked an
existing effect, or that differences do exist but are too small to detect.
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REFERENCES
1. Watanabe, H., F. Kaneko, H. Murayama, S. Yamaoka, and T. Kawaraya.
''Effects of Air Pollution on Health. Report No. 1: Peak flow rate and
vital capacity of primary school children", Reports of the Osaka City
Institute of Hygiene. Vol. 26, pp 32-37, 1964.
2. Toyama, T., "Air Pollution and Its Health Effects in Japan1', Arch.
Environ. Health, Vol. 8, pp 53-173, 1964.
3. Holland, W. W. , T. Halil, A. E. Bennett, and A. Elliott", Factors
Influencing the Onset of Chronic Respiratory Disease", Brit. Med. J.,
Vol. 21, pp 7-16, 1969.
4. Lunn, J. E., J. Knowelden and A. J. Handyside, "Patterns of Respiratory
Illness in Sheffield Infant School Children", Brit. J. Prev. Soc. Med.,
Vol. 21, pp 7-16, 1967.
5. Petrilli, F. and S. Kanitz, "Preliminary Results of the Epidemiological
Research in Genoa Dealing with Air Pollution and Its Relation to
Respiratory Function", Giorn, Igien. Med. Prev., Vol. 7, pp 205-220, 1966.
6. Anderson, D. 0. and C. Kinnis, "An Epidemiologic Assessment of a Pediatric
Peak Flowmeter", Amer. Rev. Resp. Pis., Vol. 95, pp 73-80, 1967.
7. Higgins, I. T. T., P. D. Oldham, A. L. Cochrane, and J. C. Gilson,
"Ventilatory Function in Miners: A Five Year Follow-up Study", Brit. J.
Industr. Med.. Vol. 19, pp 65-76, 1962.
8. Higgins, I. T. T., M. W. Higgins, J. C. Bilson, H. Campbell, W. E. Waters,
and B. F. Ferris, "Smoking and Chronic Respiratory Disease: Findings in
Surveys Carried Out in 1957 and 1966 in Staveley, in Derbyshire, England",
Chest, Vol. 59, pp 345-355, 1971.
9. Shy, C. M., et al, "The Chattanooga School Children Study: Effects of
Community Exposure to Nitrogen Dioxide". APCA Journal , Vol. 20, pp 539-
545, 1970.
10. Shy, C. M., et al, "Ventilatory Function in School Children, 1970-1971
Testing in N. Y. Communities", Health Consequences Sulfur Oxides: A
Report from CHESS. 1970-1971, U.S. Environmental Protection Agency,
EPA-6501, 1-74-004, 1974.
11. Wilson, M. G. and D. J. Edwards, "Diagnostic Value of Determining Vital
Capacity of Lungs of Children", J. Amer. Med. Assoc., Vol. 78 pp 1107-
1110, 1922.
12. Smillie, W. G. and D. L. Augustine, "Vital Capacity of Negro Race",
J. Amer. Med. Assoc., Vol. 87, pp 2055-2058, 1962.
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13. Roberts, F. L. and J. A. Crabtree, "The Vital Capacity of the Negro Child",
J. Aner. Med. Assoc., Vol. 88, pp 1950-1954, 1927.
14. ja~on, A., "Negro-Hhite Differences in Pulmonary Function (Vital Capacity,
Ti~ied Vital Capacity and Expiratory Flow Rate)", Human Biology, Vol. 38,
pp 380-393, 1966.
15. Health Consequences of Sulfur Oxides: A Report from CHESS, 1970-1971.
U. S. Environmental Protection Agency, EPA-6501, 1-74-004, 1974.
16. Graybill, Franklin A., An Introduction to Linear Statistical Models, Vol. I,
McGraw-Hill Book Company, Inc.. 106-147, 1961.
17. Chattanooga, Tennessee - Rossville Georgia Interstate Air Quality Study
1967-1968, U. S. Public Health Service, NAPCA Publication No. APTD-0583,
Durban, N. C., October, 1970.
18. Hauser, Thomas R., and Shy, Carl M., "Position Paper: NO Measurement",
Environmental Science and Technology. Vol. 6, pp 890-894, 1972.
8
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in
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O
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Figure 1. Air Monitoring Sites and School Locations
in the Greater Chattanooga Area
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Figure 2. N02 Sites for 1967 to 1968 Data Collected
by the Division of Abatement, National Air
Pollution Control Administration
10
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Table 1. Deletions and Subsets of the 1971-1972 Chattanooga Analysis File
tal number
IT study
Basic analysis I
'He: 4704
Delete nonwhites
Red Bank:
Brainerd:
Harrison:
No race info.
Total
16
4£3
172
38
7C9
Delete asthmatics
Red Bank: 45
Brainerd: 53
Harrison: _5_2
Total 150
Delete those witn
invalid sex or
age information:
26
Season
Deletions
38
No FEV reading
I 'Jc neignt 1
; Rejected height 3
; Incorrect mach. * 12
Tctal deletions
I I- analysis
54
972
1026
Season 2 Deletions
j So FEV reading
! Rejected FEV
j No symptom info
Total deletions
| In analysis
Total
78
2
_2
82
944
1026
Season 1 Deletions
No FEV reading 53
No height 2
Rejected height 3
No symptom info. 1
Incorrect mach. * J_0
Total deletions 74
In analysis 910
Total 984
Season 2 Deletions
No FEV reading 91
No symptom info. 1
No machine * _]_
Total deletions 93
In analysis 891
Total 984
Season 1 Deletions
No FEV reading 72
Rejected FEV 1
No height
Rejected height 1
No symptorr, info.
Incorrect mach. = 3
Total deletions
In analysis
Total
117
1310
1427
Season 2 Deletions
No FEV reading 102
Rejected FEV 1
Rejected height 6
No symptom info, 6
No machine * 20
Total deletions 137
In analysis 1290
Total 1427
Season 1 Deletions
No FEV reading 90
!lc height 4
Incorrect mach. ? 27
Total deletions 121
In analysis 1146
Total 1267
Season 2 Deletions
He FEV reading 90
Rejectee neignt 9
Nc symptom info. 7
No machine = 13
Total deletions 119
In analysis 1J4S
Total 1267
11
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Table 6. Annual Means of Aerometric Data from the
Downtown Post Office. All measurements are
in yg/tn3. TSP means are geometric; nitrate
and sulfate means are arithmetic.
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
9th St.
TSP
106.
-
113.
105.
135.
139.
131.
143.
179.
183.
146.
190.
171.
181.
215.
and Georgia Ave.
Nitrate
2.27
-
3.04
3.98
4.12
2.10
2.04
2.44
2.65
-
1.13
1.38
1.64
1.52
2.20
Post Office
Sulfate
12.7
-
10.0
13.9
9.4
8.5
9.6
9.2
9.4
-
7.0
10.5
8.9
10.5
13.3
16
-------
Table 7. Quarterly and Annual N02 Means for Two Sites at the Volunteer
Army Ammunition Plant. All measurements are in yg/m3.
Harrison School (Gate
1968
1969
1970
1971
1972
Jan-Mar
140.
135.
120.
98.
80.
Apr-June July-Sept
240.
240.
150.
103.
82.
192.
275.
101.
64.
84.
20)
Oct-Dec
199.
125.
108.
78.
71.
Annual
193.
194.
120.
86.
79.
1968
1969
1970
1971
1972
Jan-Mar
174.
125.
236.
122.
102.
Chattanooga
Apr-June
382.
361.
218.
186.
113.
Red and Gun
July-Sept
273.
370.
170.
122.
155.
Club
Oct-Dec
314.
165.
157.
133.
114.
Annual
286.
255.
195.
140.
121.
17
-------
Table 8. Division of Abatement, National Air
Pollution Control Administration,
N02 Means for September 1967 to
November 1968. All values are
arithmetic means given in yg/m3
Station
Number
5
7
15
16
17
19
20
21
27
161
201
Operating
Period
12/67 -
4/68 -
12/67 -
12/67 -
2/68 -
5/68 -
9/67 -
9/67 -
4/68 -
4/68 -
12/67 -
3/68
11/68
11/68
3/68
11/68
11/68
11/68
11/68
11/68
11/68
5/68
Number Arithmetic
Observations Mean
95 78.
233 78.
341 157.
96 59.
295 196.
202 412.
456 294.
457 176.
201 78.
230 157.
128 314.
18
-------
Table 9. Division of Health Effects, National Air
Pollution Control Administration, Pollution
Means for October 1968 to April 1969. All
values are given in yg/m3. TSP means are
geometric means; all others are arithmetic
means.
Site
Red Bank
Dl
Red Bank
D2
Bra i nerd
Cl
Brainerd
C2
Harrison
Al
Harrison
A2
Harrison
A3
NO 2
84.9
85.8
m.i
137.1
216.5
122.2
153.8
Pollutant
Nitrate
1.7
1.8
2.6
2.8
7.3
3.9
6.3
Sulfate
10.1
9.9
10.1
9.6
13.2
10.0
11.4
TSP
56.7
51.4
55.7
66.8
74.3
52.2
70.5
19
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23
-------
Table 14. Annual Pollutant Means (yg/m3) from
CHESS for 1970 to 1973
TSP
geometric mean
Site
1970a
1971
1972
Red
41
70.0
68.5
70.0
Bank
42
58.8
59.1
66.6
Bra i nerd
21
64.9
66,4
65.1
22
61.9
57.5
59.0
Harrison
31
55.0
55.9
53.7
32
55.2
55.6
53.2
33
51.0
50.8
49.6
34
40.6
42.2
43.5
35
51.5
55.1
54.3
Sulfate Fraction
arithmetic mean
1970a
1971
1972
13.4
10.3
11.1
12.0
9.3
11.1
12.7
9.7
11.3
12.3
9.4
10.6
13.0
9.6
11.1
12.2
10.1
9.8
12.4
9.8
11.1
12.6
9.7
11.7
12.9
10.3
10.7
Nitrate Fraction
arithmetic mean
1970a
1971
1972
1.2
2.4
1.1
1.0
2.0
1.1
2.0
3.1
1.6
1.4
3.0
1.5
8.4
12.9
7.1
1.8
4.1
2.3
2.1
4.8
2.5
2.0
4.6
2.0
1.7
3.2
1.7
N02
arithmetic mean
1970a
1971
1972
57.9
41.9
40.8
58.9
47.2
43.9
62.3
44.5
40.9
80.5
56.9
47.7
142.7
73.8
61.6
65.1
47.9
42.0
67.7
46.5
43.0
53.8
33.1
30.2
55.3
42.2
35.8
June through December values only.
24
-------
Table 15. Height, Age, Machine, and Symptom
Adjusted Mean FEV0>75 Distributed
by Community and by Season
Age < 108 Months
Community
Red Bank
Bra i nerd
Harrison
Males
Winter
1.313
(329)a
1.300
(267)
1.286
(376)
Spring
1.340
(308)
1.308
(268)
1.368
(368)
Average
1.334
(298)
1.311
(260)
1.331
(351)
Females
Winter
1.187
(315)
1.173
(248)
1.202
(347)
Spring
1.211
(298)
1.193
(251)
1.261
(342)
Average
1.204
(288)
1.185
(234)
1.237
(315)
Age > 108 Months
Community
Red Bank
Brainerd
Harrison
Males
Winter
1.824
(513)
1.810
(358)
1.797
(439)
Spring
1.848
(507)
1.807
(351)
1.861
(432)
Average
1.835
(494)
1.806
(336)
1.826
(413)
Females
Winter
1.745
(446)
1.734
(345)
1 .706
(355)
Spring
1.764
(443)
1.761
(345)
1.781
(360)
Average
1.755
(424)
1.747
(325)
1.751
(331)
( ) indicates sample size for that mean.
25
-------
Table 16. F Values for Analysis of Variance,
Distributed by Season and by Sex
Factor
Males < 108 Months
Height
Age
Machines
Symptom
Community
Females < 108 Months
Height
Age
Machines
Symptom
Community
Males > 108 Months
Height
Age
Machines
Symptom
Community
Females > 108 Months
Height
Age
Machines
Symptom
Community
D.F.a
1
1
1
1
2
1
1
1
1
2
1
1
1
1
2
1
1
1
1
2
Winter
353.39***
23.76***
1.34
7.61**
1.69
343.89***
12.47***
.20
1.40
1.93
730.75***
38.31***
16.47*** -
3.54
1.69
757.39***
36.98***
3.00
2.91
2.80
Spring
391.57***
15.50***
1 1 . 30***
.05
7.41**
352.58***
16.55***
1.11
2.58
12.63***
853.27***
7.89**
3.84
.67
5.97**
867.61***
2.18
11.1 6***
12.71***
0.76
Average
457.30***
19.02***
1.49
409.30***
13.56***
8.11***
905.44***
12.82***
1.94
979.28***
10.08**
0.14
**
***
Degrees of freedom of the numerator.
denominator are given in Table 17.
p < 0.05
p < 0.01
p < 0.001
The degrees of freedom for the
-------
Table 17. Height, Age, Machine, and Community
Adjusted Mean FEVg^ Distributed by
Symptoms and Season
Age < 108 Months
No Symptoms
Symptoms
Males
Winter
1.310
(694)
1.272
(278)
Spring
1.343
(776)
1.339
(168)
Females
Winter
1.196
(576)
1.180
(334)
Spring
1.220
(676)
1.242
(215)
Age >_ 108 Months
No Symptoms
Symptoms
Males
Winter
1.817
(1061)
1.787
(249)
Spring
1.843
(1143)
1.827
(147)
Females
Winter
1.737
(815)
1.711
(331)
Spring
1.781
(914)
1.719
(234)
27
-------
Table 18. Regression Coefficients for Height
and Age Distributed by Sex and Age
Males < 108 months
Height (liters/inch)
Age (liters/month)
Females < 108 months
Height (liters/inch)
Age (liters/month)
Males > 108 months
Height (liters/inch)
Age (liters/month)
Females > 108 months
Height (liters/inch)
Age (liters/month)
Regression Coefficients
Winter
.0538
.0040
.0522
.0028
.0619
.0038
.0661
.0045
Spring
.0614
.0034
.0539
.0033
.0725
.0018
.0740
.0011
Average
.0603
.0034
.0542
.0028
.0707
.0021
.0724
.0022
28
-------
Table 19. Mean Heights and Ages of Those in the Analysis,
by Sex and Age
Males < 108 months
Height (inches)
Age (months)
Females < 108 months
Height
Age
Males > 108 months
Height
Age
Females > 108 months
Height
Age
Winter
50.297
91.702
49.968
91.467
56.609
127.743
56.906
127.482
Spring
50.623
93.975
50.191
93.629
56.750
129.689
57.072
129.287
Average
50.501
92.970
50.110
92.658
56.659
128.628
57.027
128.331
29
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Table 20. Mean Square Error of FEV Analyses By Season
Age-Sex Group
Males < 108 Months
Females < 108 Months
Males >_ 108 Months
Females >_108 Months
Winter
.0361
(965)a
.0309
(903)
.0483
(1303)
.0538
(1139)
Spring
.0378
(937)
.0300
(884)
.0501
(1283)
.0543
(1141)
Average
.0300
(504)
.0243
(832)
.0425
(1238)
.0433
(1075)
( ) indicates degrees of freedom.
30
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TECHNICAL REPORT DATA
/Please read Instructions on the reverse before completing)
1 REPORT NO.
EPA-600/1-77-002
3. RECIPIENT'S ACCESSIOr+NO.
L
4 TITLE AND SUBTITLE
LUNG FUNCTION IN SCHOOL CHILDREN: 1971-1972
CHATTANOOGA STUDY
5. REPORT DATE
January 1977
6. PERFORMING ORGANIZATION CODE
7 AUTHOR(S)
Victor Hasselblad
8. PERFORMING ORGANIZATION REPORT NO.
9. PERFORMING ORGANIZATION NAME AND ADDRESS
Statistics and Data Management Office
Health Effects Research Laboratory
Research Triangle Park, N.C. 27711
10. PROGRAM ELEMENT NO.
11. CONTRACT/GRANT NO.
12. SPONSORING AGENCY NAME AND ADDRESS
Health Effects Research Laboratory
Office of Research and Development
U.S. Environmental Protection Agency
Research Triangle Park, N.C. 27711
13. TYPE OF REPORT AND PERIOD COVERED
Tn Hnn<;p
14. SPONSORING AGENCY CODE
EPA-ORD
15. SUPPLEMENTARY NOTES
16. ABSTRACT
Previous studies of lung function in children have indicated that decreases
in lung function are associated with higher air pollution exposures. For this
reason, three quarter second timed forced expiratory volume was chosen as one
of the health indicators in the Environmental Protection Agency's Community
Health Environmental Surveillance System (CHESS). The city of Chattanooga,
Tennessee was chosen because of its exposure to a large stationary source of
nitrogen dioxide. The present study, conducted
to an earlier study performed by Shy, et al. in
did not confirm the slight differences found in
in 1971-1972, was a follow-up
1968-1969. The present study
the earlier study. This might
be explained by the reduction in N02 levels since the 1968-1969 study.
17.
a
KEY WORDS AND DOCUMENT ANALYSIS
DESCRIPTORS
Lung
Respiratory system
Children
Air Pollution
b.IDENTIFIERS/OPEN ENDED TERMS
Chattanooga
c. COSATI I icld/Group
06 F
13. DISTRIBUTION STATEMEN1
RELEASE TO PUBLIC
19 SECURITY CLASS fThis Report)
UNCLASSIFIED
21. NO. OF PAGES
35
20 SECURITY CLASS (Tmspagef
IJNCLASSTFTFD
22. PRICE
EPA Form 2220-1 (9-73)
31
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