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Asthma in the Bronx: New Research on Air Pollution's Role

Asthma in the Bronx
Reported by
Christine Van Lenten

Posted June 07, 2007


In the Bronx, rates of asthma, while somewhat lower than they've been, are still so high that asthma constitutes a chronic epidemic. The City's Asthma Initiative reports that rates tend to be highest in the lowest-income neighborhoods; hospitalization rates are highest for children. New York City ranks third on a list of the 50 U.S. cities with the largest numbers of children exposed to dirty air.

Organized at the urgings of community groups concerned about high rates of asthma in the South Bronx and other areas of New York City, a panel of researchers convened at the Academy on January 23, 2007, to share the findings of their studies on asthma in the city.

Web Sites


California Air Resources Board
The most aggressive air-quality regulator in the nation, CARB offers extensive online information about its work. See, for example, pages on its Air Toxics Program and its Diesel Risk Reduction Plan.

Children's Health Study
Initiated by CARB, this is a major, long-term study of the effects of chronic air pollution exposures on the health of children living in Southern California. CARB funding ended in 2004, but the National Institute of Environmental Health Sciences provided funding for an additional three years. The CARB Web page devoted to the study isn't up to date but is still valuable.

San Pedro Bay Clean Air Action Plan
This historic $2 billion plan was adopted in November 2006 by the Ports of Los Angeles and Long Beach with the cooperation and participation of CARB, the South Coast Air Quality Management District, and U.S. EPA. To significantly reduce health risks, it commits the ports to an aggressive plan to reduce air pollution by at least 45% in the next five years—at the same time that the ports, among the largest in the world, continue to grow. All port-related emission sources—ships, trains, trucks, terminal equipment, and harbor craft—are covered. The area around the ports has been termed "Diesel Death Valley" by local residents.

Centers for Disease Control and Prevention
Its Web site treats the subject of asthma exhaustively, offering not only medical information and data but information about legislation and programs at the federal and state levels. See the study, The State of Childhood Asthma, United States, 1980–2005 (PDF, 365 KB).

Agency for Toxic Substances and Disease Registry
Congress created this agency in 1980 to implement the health-related sections of laws that protect the public from hazardous wastes and environmental spills of hazardous substances. Searching its Web site for "asthma" yields a list of studies with links to full text.

National Center for Environmental Health
The center offers information on many aspects of asthma as a disease and a public health problem.

Environmental Protection Agency
See pages on diesel, the National Clean Diesel Campaign, particulate matter, fine particle (PM2.5) designations, recent revisions of PM2.5 standards, reports on air quality (Air Trends reports), the Toxic Release Inventory, National Emissions Inventory, and environmental justice. A March 2, 2007, news release announces a proposed rule to drastically cut diesel emissions from engines that power trains and marine vessels (but not oceangoing ships, which EPA cannot directly regulate).

National Institutes of Health (NIH)
See this Community Participation in Research solicitation, which is intended to "support research on health promotion, disease prevention, and health disparities that is jointly conducted by communities and researchers."

National Institute of Environmental Health Science (NIEHS)
NIEHS studies the relationship between the environment and human health. It supports Community-Based Participatory Research, which it defines as "a methodology that promotes active community involvement in the processes that shape research and intervention strategies, as well as in the conduct of research studies."

Its Centers for Children's Environmental Health and Disease Prevention supports multidisciplinary basic, applied, and community-based participatory research. Findings are communicated to clinical and public health professionals and policy makers. Columbia University's Center for Children's Environmental Health is one grantee.

See, too, information for children on the concept of environmental justice.

New York City

This Web site is devoted to Mayor Michael Bloomberg's long-term sustainability plan. The site is wonderfully informative, clearly written, handsome, and loaded with great photos and graphics. But it's somewhat confusing to navigate, lacks a site map, and presents most information in the form of PDF files. Persistence is required. See the chapter on air.

See, too, Mayor Bloomberg's May 30, 2007, press release reporting, at length, on the news conference that he and Manhattan Borough President Scott Stringer held to announce the creation of an Asthma Center of Excellence that is intended to reduce asthma hospitalizations in East Harlem by 50 percent by 2010.

Department of Environmental Projection
Scroll down for information about City laws requiring the use of ultra low sulfur diesel fuel.

Department of Health
Its Asthma Initiative offers data on asthma hospitalizations for children, neighborhoods, and boroughs, in text, figures, and tables. See, too, information on the New York City Asthma Partnership, a coalition of over 300 individuals and organizations who want to reverse the asthma epidemic in New York City. And see community health profiles of neighborhoods.

New York State

Department of Environmental Conservation
DEC's Ambient Air Quality Monitoring Program measures air pollutants at more than 80 sites across the state, using continuous and/or manual instrumentation. These sites are part of the federally mandated National Air Monitoring Stations Network and the State and Local Air Monitoring Stations Network. See the map indicating air-monitoring locations in New York City. And, see the many pages on environmental justice, including GIS maps.

Department of Health
Its Web site offers extensive information about asthma, and it sponsors a NYC Asthma Partnership, a coalition of individuals and organizations working to reverse the asthma epidemic. See, too its page on Health & Safety in the Home, Workplace and Outdoors, which includes links to information on air quality.

New York State Office of the Attorney General
This office can be a tremendous force for good. Unfortunately its minimal Web site conceals this fact well. But do see the 2003 press release on reducing diesel emissions at Hunts Point in the Bronx.

NGO and Business

American Lung Association
ALA's web site offers information on many aspects of asthma. ALA is a party to litigation brought against EPA in December 2006 over the NAAQS for annual levels of PM2.5. See too its December 2006 criticism of EPA for weakening its process for reviewing standards.

Asthma Free School Zone
This New York City-based nonprofit gives environmental health training to school and community members, and it guides grassroots creation and maintenance of safe, healthy school zones in which children are protected from risks associated with poor air quality.

Clean Air Task Force
Scientific research, public education, and legal advocacy are this nonprofit's tools. See its extensive Diesel Project and its February 2008 publication No Escape from Diesel Exhaust, which reports on an investigation of harmful commuter exposures to diesel particles during typical commutes in Austin, Texas; Boston; Columbus, Ohio; and New York City. The brief foreword, written by George Thurston, is an exceptionally lucid description of the problem.

Environmental Defense
See this influential NGO's March 2007 report, All Choked Up: Heavy Traffic, Dirty Air and the Risk to New Yorkers (PDF, 8.7 MB). See, too, its endorsement of Mayor Bloomberg's plaNYC, and its pages on clean air. Topics include Pollution Solutions/Tailpipes and Dirty Air and Your Health, which in turn includes Smog & Soot and Asthma and Air Pollution.

Environmental Integrity Project
Environmental laws "are impressive in scope; in practice, they are often ignored," says this invaluable NGO. It works closely with local communities to protect the public's health and resources by promoting better enforcement of federal environmental laws. EIP also seeks to protect these laws from political interference.

The granddaddy of GIS. See the pages on health, including case studies. Subscriptions to the quarterly e-newsletter Healthy GIS are free.

WIN for Asthma (Washington Heights/Inwood Network for Asthma) in New York City is a grantee of the Merck Childhood Asthma Network, with a four-year research agenda and an impressive list of participants and collaborators. Outdoor air pollution is not on its agenda.

Northeast Diesel Collaborative
This public-private partnership, which includes EPA and state officials, employs a variety of strategies regionally and locally to reduce diesel emissions. Its Web site offers lots of valuable information, including a page on Diesel 101.

Enter your zip code to access data on pollution in your community. This site offers lots more information, too, including sources of data and an overview of criteria pollutants.

South Bronx Environmental Justice Partnership
This collaborative venture's ambitious agenda includes asthma and air quality issues.

Sustainable South Bronx
This organization, founded in 2001 by MacArthur Foundation Fellow Majora Carter, pursues environmental justice through innovative, economically sustainable projects informed by the needs of the community. It also addresses land-use, energy, transportation, water and waste policy, and education, toward advancing the environmental and economic rebirth of the South Bronx.

West Harlem Community Action (We Act)
This community-based nonprofit applies the principles of environmental justice to the pursuit of environmental health for Northern Manhattan residents, many of whom are Latino and African-American. It partnered in George Thurston's study. See its pages on GIS mapping and environmental justice.

Publications and Video

Asthma symptoms linked to soot particles from diesel trucks in South Bronx. 2006. New York University press release. (October 16).

Bari A, Ferraro V, Wilson LR, et al. 2003. Measurements of gaseous HONO, HNO3, SO2, HCl, NH3, particulate sulfate and PM2.5 in New York, NY. Atmos. Environ. 37: 2825-2835.

Bari, A, Dutkiewicz, VA, Judd, CD, et al. 2003. Regional sources of particulate sulfate, SO2, PM2.5, HCl, and HNO3, in New York, NY. Atmos. Environ. 37: 2837-2844.

Boss, LP, Kreutzer, RA, Luttinger, et al. 2001. The public health surveillance of asthma. J. Asthma 38: 83-89.

Brown P et al. 2004. Clearing the air and breathing freely: the health politics of air pollution and asthma. Int. J. Health Serv. 34: 39-63.

Brown P et al. 2003. The health politics of asthma: environmental justice and collective illness experience in the United States. Soc. Sci. Med. 57: 453-464.

Corburn J, Osleeb J, Porter M. 2006. Urban asthma and the neighbourhood environment in New York City. Health Place 12: 167-179.

Devouassoux G, Saxon A, Metcalfe DD, et al. 2002. Chemical constituents of diesel exhaust particles induce IL-4 production and histamine release by human basophils. J. Allergy Clin. Immunol. 109: 847-853.

Eder W, Ege MJ, von Mutius E. 2006. The asthma epidemic. N. Engl. J. Med. (November 23.) (PDF, 305 KB) Full Text

Eggleston PA, Diette G, Lipsett M, et al. 2005. Lessons learned for the study of childhood asthma from the Centers for Children's Environmental Health and Disease Prevention Research. Environ. Health Perspect. 113: 1430-1436. Full Text

Fernandez M. 2006. A study links trucks' exhaust to Bronx schoolchildren's asthma. The New York Times. (October 29) (limited access)

Hempel S. 2007. The Strange Case of the Broad Street Pump. University of California Press, Berkeley.

Lin S, Hwang SA, Pantea C, et al. 2004. Childhood asthma hospitalizations and ambient air sulfur dioxide concentrations in Bronx County, New York. Arch. Environ. Health 59: 266-275.

Maantay J. 2002. A video, "A University on the Move," made by the City University of New York's "Study with the Best" TV show, includes a segment in which Maantay explains her use of GIS to examine data relevant to asthma rates in the Bronx. Fast-forward to 15 minutes 30 seconds to view it.

Maantay J, Ziegler J. 2006. GIS for the Urban Environment. ESRI Press, Redlands, CA.

Researchers uncover link between asthma and air pollution in the Bronx. 2007. Lehman College Web site article reporting on Juliana Maantay's work. (February 5)

Maugh II, TH. 2007. Freeways' tainted air harms children's lungs, experts say. Los Angeles Times. (January 26) [Registration, free, required.] This article reports that University of Southern California researchers found "lifelong damage" in a "13-year study of 3600 Southland youngsters living within 500 yards of a highway."

Natural Resources Defense Council and the Coalition for Clean Air. 1998. Exhausted by Diesel: How America's Dependence on Diesel Engines Threatens Our Health. The report states that "The only reasonable conclusion one can draw from the massive scientific evidence is that exposure to diesel exhaust significantly increases human health risks."

NYU Study Links Bronx Pollution To Asthma. 2006. WNBD-TV 4NEWS video. (October 16)

Pastor, Jr, M, Morello-Frosch, R, Sadd, J. 2007. Still Toxic After All These Years: Air Quality and Environmental Justice in the San Francisco Bay Area. Center for Justice, Tolerance, and Community, an applied research center at the University of California, Santa Cruz.

Schauer J J. 2003. Evaluation of elemental carbon as a marker for diesel particulate matter. Nature Vol. 13, No. 6, pages 443-453. (November)

Sze J. 2006. Noxious New York: the racial politics of urban health and environmental justice. MIT Press, Cambridge, MA. See the chapter titled "Childhood Asthma in New York: The Politics of Gender, Race, and Recognition." This book references Juliana Maantay's work (page 41).


A. Hal Strelnick, MD

Albert Einstein College of Medicine
e-mail | web site | publications

Alvin (Hal) H. Strelnick is professor of clinical family and social medicine at the Albert Einstein College of Medicine and director and founder of its Institute for Community and Collaborative Health and the Hispanic Center of Excellence. He is principal investigator of the NIH-funded Bronx Center to Reduce and Eliminate Ethnic and Racial Health Disparities (Bronx CREED) and the South Bronx Environmental Justice Partnership. He also holds adjunct appointments at the Columbia University School of Public Health and City University of New York Medical School.

Since 1978 he has practiced clinical and social medicine in the Bronx and Yonkers, dedicating his career to minority health and health disparities. He leads New York State's first and only Hispanic Center of Excellence and the NIH Project EXPORT Center of Excellence, and he mentors many minority health leaders.

Strelnick received his medical degree from Yale and completed his residency in family medicine at Montefiore Medical Center's Residency Program in Social Medicine in the Bronx. After graduating he continued his practice at the Dr. Martin Luther King, Jr., Health Center in the South Bronx, as a member of the National Health Service Corps, writing a grant to open a new satellite center, the first of four health centers he helped to start. In 1981 he joined the Einstein and Montefiore faculty to teach community health.

During the 1980s he was promoted to deputy chair and project director for the Valentine Lane Family Practice. He began Montefiore's Health Care for the Homeless Outreach Program and became a Kellogg National Leadership Fellow. In 1999, with the support of the Dean, Strelnick founded the Einstein Institute for Community and Collaborative Health, which now has an operating budget of almost $3 million.

Strelnick has received numerous awards, and after moving his practice back to the Bronx in 2000, he has been named to the Best Family Physicians list of New York magazine and the Castle-Connolly Guide every year but one.

Juliana A. Maantay, PhD

Lehman College, City University of New York
e-mail | web site | publications

Juliana Astrud Maantay is an associate professor of urban and environmental geography at Lehman College, City University of New York, and director of Lehman's Geographical Information Science (GISc) Program. She also is a faculty member in the Earth and Environmental Sciences PhD program at the CUNY Graduate Center and a research scientist with NOAA-CREST, the National Oceanic and Atmospheric Administration Center of Remote Sensing Science and Technology, at City College.

She has over 20 years experience as an urban and environmental planner and policy analyst with governmental agencies, nonprofit organizations, and private sector consulting firms. She has been active in environmental justice research and advocacy for more than 10 years. She was employed as senior environmental planner by the NYC Department of Environmental Protection and the NYC Department of City Planning, and she served as associate director of the Center for a Sustainable Urban Environment at Hostos Community College in the Bronx.

Her recent research on environmental health justice has been published in the American Journal of Public Health, Environmental Health Perspectives, Health and Place, and the Journal of Law, Medicine, and Ethics. Her work also appears in volumes on urban public health issues and health inequities. Her book, GIS for the Urban Environment, was published in 2006 by ESRI Press (Environmental Systems Research Institute). Specified as a textbook for GIS courses in universities around the country, it is on the "Top Books of 2007" list of Planetizen, an urban planning, design and development group. In 2007 the book won an award in the annual map design competition hosted by the American Congress on Surveying and Mapping/Cartography and Geographic Information Society.

Maantay has presented her research on environmental justice and health disparities to many leading government agencies, educational institutions, and other organizations, and at conferences. One of her other major areas of research is the use of participatory GISc for community-based organizations, and she is a co-principal investigator of the South Bronx Environmental Justice Partnership.

She holds a PhD in urban environmental geography from Rutgers University, a Master of Urban Planning from New York University, and an MA in environmental geography/geographic information systems from Hunter College/CUNY.

George D. Thurston, ScD

New York University School of Medicine
e-mail | web site | publications

George D. Thurston is an associate professor at the New York University (NYU) School of Medicine's Department of Environmental Medicine. He conducts epidemiological research into the human health effects of air pollution and is a co-investigator on the South Bronx Environmental Health and Policy Study. He served as director of the NYU-NIEHS Community Outreach and Education Program (1995–2004) and as deputy director of NYU's EPA Particulate Matter Health Effects Center (2002–2005).

Thurston has published widely in the scientific literature on the assessment of exposures to ambient air pollution and their human health consequences. He has also testified before the U.S. Senate and the U.S. House of Representatives on many occasions about the potential effects on human health of air pollution in the United States and about the human health consequences of pollution resulting from the 2001 World Trade Center disaster.

His participation in many professional organizations includes his service as an associate editor of the International Society of Exposure Analysis's Journal of Exposure Analysis and Environmental Epidemiology and as a co-organizer and host of the International Society for Environmental Epidemiology's annual meeting in New York City in August 2004.

Gregg M. Recer, PhD

New York State Department of Health
e-mail | web site | publications

Gregg M. Recer has worked as a research scientist at the New York State Department of Health's Center for Environmental Health since 1990. His work there focuses on applied environmental health research investigating the potential for adverse health effects from exposure to environmental chemicals and biological agents.

His main research areas include evaluating the potential adverse effects of airborne exposures to ambient criteria pollutants, volatile organic chemicals and bioaerosols in indoorand outdoor environments. Other areas of interest include environmental assessment and response for biothreat agents and applying statistical modeling techniques including physiologically-based pharmacokinetic models and Monte Carlo methods to evaluate chemical exposure-response relationships and dosimetry scaling.

Recer received BS and MS degrees in biology from Rensselaer Polytechnic Institute and a PhD in environmental health and toxicology from the University at Albany.

Patrick L. Kinney, PhD

Mailman School of Public Health, Columbia University
e-mail | web site | publications

Associate professor of environmental health sciences at Columbia University's Mailman School of Public Health, Patrick L. Kinney is an air pollution epidemiologist with a strong interest in exposure assessment.

He has carried out many epidemiologic studies addressing the human health effects of air pollution, including studies of the effects of ozone and particulate matter on children's lung function and on daily mortality in large cities. His recent work has focused on characterizing levels and determinants of indoor, outdoor, and personal exposures to air pollution in the underprivileged neighborhoods of New York City, including studies of indoor allergens, diesel vehicle emissions, volatile organic compounds, PAHs, and other air toxins.

Kinney directed an intervention trial, funded by the National Institute of Environmental Health Science, that is seeking ways to reduce exposures to indoor allergens among asthmatic children living in Northern Manhattan and the South Bronx. He is also the principal investigator of a study characterizing air toxin exposures among minority high school students living in New York City and Los Angeles.

He codirects the Exposure Assessment Cores of the Columbia Center for Children's Environmental Health and the Center for Environmental Health in Northern Manhattan. He also leads the New York Climate and Health Project, which is developing and testing an integrated modeling system for assessing potential future air quality and health effects of climate and land use changes in the NYC metropolitan area.

Christine Van Lenten


Christine Van Lenten is a freelance writer who has written about varied subjects for the Academy. She has also written about public policy issues and technical and scientific subjects—many of them in the environmental field—for federal and state agencies, nonprofit organizations, and private sector firms.