Reference no: EM131229966

Malig BJ et al. (2013). Coarse particles and respiratory emergency department visits in California. American Journal of Epidemiology. 178(1):58-69.

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Public Health Significance
Clean air is a critical topic in many public health regulatory policies, such as EPA (Environmental Protection Agency), and the USA has many regulator committees that ensures industries, car owners and other business are regulated on the levels of pollutants that enters into the air, which ultimately will be inhaled by humans and cause acute or chronic illnesses such as asthma, COPD, heart attacks, and strokes.Malig, Green, Basu, Broadwin, (2013) discussed PM2.5 (fine particles) and PM10 (coarse particles) which are made of various environmental pollutants that circulates the air, and enters the human bodies via the respiratory system, which has caused an increase in air pollutant asthmas cases in California.

Global or Local impact
Although, Malig et al. (2013) research study focused mainly on the West USA, California counties (58), pollutants such as, CO2, O3, Nitrogen dioxide (NO2), Carbon Monoxide (CO), Sulfur dioxide (SO2), that affected many residents respiratory systems, air pollution is a global public health issue.

Public Health GAP
There is much research on hazard pollutants within the environments that may affect humans health, therefore, I do not think that this research filled any unknown public health gap; however, it did bring to light the amount of air pollutants that possible caused increase asthma cases in the study area within a 20 km radius of the air monitoring equipment

Critique of Methodology
The method in which Malig et al. (2013) conducted the research was sound in that they collected previously known emergency room visits, inpatient and outpatient visit of patients that had been diagnosed with some form of breathing problems such as asthma, COPD(chronic obstructive pulmonary disease), coughs, and other breathing problems that could be caused by air pollutants. Pollination-weighted centroid for each patient record for residential zip code for precise location of the study. Exposure was assigned from pollutants monitor available data for the same day. Pollution validation of exposure was done by using zip codes of cases within 20 km of reporting monitor. Geographic assignment was performed with Arc GIS 9.2 with Hawth's Tool Extension.

The researchers deducted the PM2.5 from PM10 to monitor the finer particles from the coarse particles, and each were measured separately on the same day, so that each pollutants could be tested to indicate which is possible cause of emergency room visit with in the area. The data was analyzed using SAS (version 9.2). Counties with at least 50 cases of emergency room visit were included in the overall estimation for pollutants.

Interpretation of Study Results
Overall the study results indicated that residents that had visited the California emergency rooms with breathing problems were caused by PM10(coarse pollutants) proven to be statistically significant in those residents that had been diagnosed with asthma, but there were no evident that individuals that suffered from COPD, was caused by air pollutants.

Agree or Disagree with Results
I do agree with Malig et al. (2013) research results because they provided many statistical reports in the study that supported their results. I am not sure if testing on whether different ethnical groups were more affected had than the other groups really brought to light a problem with the overall purpose for the study, which was whether or not PM2.5 or PM10 caused the increase emergency room visits due to asthma cases.

Social Change Impact
Additional, Malig et al. (2013) research will have a social change impact, especially in the study area, in that it will allow environmental committees to reevaluate the safe-levels amounts in California, as well as, implement risk assessment and risk management plans.

Reasonable Actions
There are no public health reasonable actions that will need to take, other than continue to monitor and report any high levels of any pollutants, especially PM10, which is reported to have caused the increase of asthma attacks in the area.

Precautionary Actions
Public health leaders may want to take precautionary actions by reporting the Malig et al. (2013) to the clean air committee, and place some form of public health notice in the study area that has the highest number of asthma attacks from pollutants. Also, protection methods, such as breathing apparatus could be suggested in high related polluted areas, so that the public could at least have the choice in breathing in unsafe air.

Other Research Studies in Support or Contrary to the Study
Although Malig et al. (2013) research study indicated that the PM10 particles caused more caused the highest number of emergency room visits asthma cases in California, USA.

In contrast, Cheng, Chiu, and Yang (2015) research study on air pollution particles PM2.5 and PM10 indicates that it is the finer air particles that can cause the most damages health care problems in Twain, because some of the smaller particles (CO2) are able to past beyond the protective linings of the lungs and into the blood stream, which could cause heart attacks or strokes, by reducing the amount of oxygen in the cells, which will later die.

Finally, Sun, Chou, and Lue (2006) research study indicates that children are more vulnerable to various air pollutants (CO, SO2, and PM10) than adults, because of the higher amount of ventilations, which may enter into their lungs at a faster rate. Overall, all the researchers agreed that air pollutants are the causes of high increase of asthmas and other respiratory problems within various communities both national and globally. There is a need for a continuous day-to-day monitoring of all air pollutants by groups such as EPA (Environmental Protection Agency) in order to maintain a safety level within the environment to protect public from dangerous air pollutants.

References
Malig, B., Green, S., Basu, R., Broadwin, R. (July, 2013). Coarse Particles and Respiratory Emergency Department Visits in California. American Journal of Epidemiology.178(1):5869. Retrieved from Walden University Library.

Cheng, M., Chiu, H., & Yang, C. (2015). Coarse particulate air pollution associated with increased risk of hospital admissions for respiratory diseases in a tropical city, Kaohsiung, Taiwan. International Journal of Environmental Research and Public Health, 12(10), 13053-13068. Retrieved from https://search.proquest.com.ezp.waldenulibrary.org/docview/1733897534?

Sun, H., Chou, M., & Lue, K. (2006). The relationship of air pollution to ED visits for asthma differ between children and adults. The American Journal of Emergency Medicine, 24(6), 709-13. doi:https://dx.doi.org/10.1016/j.ajem.2006.03.006