although still present in those who lived only at
the 2 to 5 mile distance. This apparent increase in
thyroid disease also could have been the result of
using different methods of collecting data about
disease conditions, since the FMMP data were
obtained during physician medical history taking,
while the NHIS and NHANES data were col-
lected with in-person interviews.
Impact of Ambient Hydrogen
Sulfide and Total Reduced Sulfur
Levels on Hospital Visits for
Respiratory Diseases in Dakota
ATSDR's Dakota City site office
City and South Sioux City,
day. A positive association also was found
Nebraska
between hospital visits for all respiratory dis-
In response to community concerns about high
levels of hydrogen sulfide in the outdoor air
reduced sulfur levels on the previous days, but
in Dakota City, Nebraska, ATSDR examined
only for children, not for adults. No association
the association between total reduced sulfur and
and hospital visits by adults or children for
asthma and all respiratory diseases. This investi-
all digestive diseases, which was a comparison
gation was designed to take advantage of ambi-
diagnostic category.
ent air monitoring data that had been collected
This is the first epidemiologic study to examine
by EPA to support a separate epidemiologic
variations in ambient air levels of hydrogen sul-
investigation of neurobehavioral health status.
fide and hospital visits for respiratory diseases.
levels were characterized as high if at least one
or hydrogen sulfide levels may be associated
of the daily rolling averages was at least 30 ppb
with exacerbations of asthma or all respiratory
and low if the rolling average was less than 30ppb
diseases among the residents of Dakota City and
(the ATSDR MRL for intermediate exposure).
South Sioux City.
A positive association for children less than 18
years of age was found between hospital visits
sented at a public meeting in Dakota City
for asthma or respiratory illness and a measure-
in May 2001. Community residents viewed
ment of high total reduced sulfur levels on the
these results as validating their health concerns.
previous day. Hospital visits for children with
respiratory illness was an average of 27% higher
air contaminant, these results are also of interest
on days following high total reduced sulfur
to the broader environmental health community.
levels and 65% higher for those children with
These findings, although somewhat exploratory,
asthma. A positive association for adults was
offer an important hypothesis worthy of further
also found between asthma hospital visits and
examination.
chapter 3 49
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