Urban air quality and associations with pediatric multiple sclerosis

Amy M. Lavery, Emmanuelle Waubant, T. Charles Casper, Shelly Roalstad, Meghan Candee, John Rose, Anita Belman, Bianca Weinstock-Guttman, Greg Aaen, Jan Mendelt Tillema, Moses Rodriguez, Jayne Ness, Yolanda Harris, Jennifer Graves, Lauren Krupp, Leigh Charvet, Leslie Benson, Mark Gorman, Manikum Moodley, Mary RenselManu Goyal, Soe Mar, Tanuja Chitnis, Teri Schreiner, Tim Lotze, Benjamin Greenberg, Ilana Kahn, Jennifer Rubin, Amy T. Waldman

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background: We previously identified air quality as a risk factor of interest for pediatric multiple sclerosis. The purpose of this study is to more closely examine the association between the six criteria air pollutants and pediatric MS as well as identify specific areas of toxic release using data from the Toxic Release Inventory. Methods: Pediatric MS cases (N = 290) and healthy controls (N = 442) were included as part of an ongoing case–control study. We used the National Emissions Inventory system to estimate particulate exposure by county of residence for each participant. Proximity to Toxic Release Inventory (TRI) sites was also assessed using ArcGIS mapping tools. Risk-Screening Environmental Indicators (RSEI) classified counties at risk to exposure of environmental toxic releases. Results: Fine particulate matter (PM2.5), carbon monoxide (CO), sulfur dioxide (SO2), and lead air emissions were associated with increased odds for pediatric MS (P < 0.01) for those residing within 20 miles of an MS center. Most study participants (75%) resided within 5 miles of at least one TRI site; however, the mean total pounds of stack air releases was higher for sites near MS cases (81,000 tons) compared to those near healthy controls (35,000 tons, P = 0.002). Average RSEI scores did not differ significantly between cases and controls. Conclusion: Out of several air pollutants examined, we show that fine particulate matter and three other criteria pollutants (SO2, CO, and lead) were statistically associated with higher odds for pediatric MS.

Original languageEnglish
Pages (from-to)1146-1153
Number of pages8
JournalAnnals of Clinical and Translational Neurology
Issue number10
StatePublished - Oct 2018


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