Proximity to two main sources of industrial outdoor air pollution and emergency department visits for childhood asthma in Edmonton, Canada.

OBJECTIVE: Children are recognized to be more susceptible than healthy adults to the effects of air pollution; however, relatively few Canadian studies of children have focused on industrial emissions. We conducted a spatial cross-sectional study to explore associations between emergency department (ED) visits for childhood asthma and residential proximity to two industrial sources of air pollution (coal-fired power plant and petrochemical industry) in Edmonton, Canada. METHODS: Using administrative health care data for Alberta between 2004 and 2010, we conducted a spatial analysis of disease clusters of count data around these two industrial sources. The distance from children's place of residence to these industrial sources was determined by using the six-character postal code from the children's ED visit. Clusters of cases were identified at the census dissemination area. Negative binomial multivariable spatial regression was used to estimate the risks of clusters in relation to the distance to these industrial sources. RESULTS: The relative risk of ED visits for asthma, calculated using a spatial scan test for events, was 10.4 (p value <0.01) within the power plant area when compared with the outside area. In addition, there was an inverse association of the distance to the power plant (coefficient = -0.01 per km) with asthma visits when multivariable models were used. No asthma clusters were identified around the petrochemical industrial area. CONCLUSION: Our analyses revealed that there was a cluster of ED visits for asthma among children who lived near the coal-fired power plant just outside Edmonton.

Use of paralysis in silo-assisted closure of gastroschisis.

OBJECTIVE: To examine the association between pre-closure neuromuscular paralysis and time to final surgical closure for infants with gastroschisis undergoing silo reduction. STUDY DESIGN: This study was an exploratory review of observational variables obtained from the Canadian Pediatric Surgery Network database. The focus was on the subset of infants with gastroschisis undergoing silo reduction between May 2005 and March 2009. Of the 186 infants, paralysis use could be ascertained for 167 infants (79 received pre-closure paralysis and 88 received none). Groups were compared by using statistical tests, with relationships explored using regression analysis. RESULTS: Infants receiving paralysis took longer to achieve closure by an average of 3 days (8 versus 5 days; P < .001) and had greater mean number of ventilation days (12 versus 7 days; P < .001). The relationship between paralysis and days to closure remained after adjusting for other variables. CONCLUSIONS: In infants with gastroschisis undergoing silo reduction, use of paralysis was associated with longer time to closure. Pre-closure paralysis should be carefully weighed in this population.

Metabolic risk varies according to waist circumference measurement site in overweight boys and girls.

OBJECTIVES: To compare waist circumference (WC) values measured at 4 commonly recommended sites and examine the relationships between WC sites and markers of metabolic risk in a sample of overweight boys and girls referred for weight management. STUDY DESIGN: Overweight (mean body mass index percentile, 98.7; SD, 1.0) children and adolescents (n = 73; 41 girls, 32 boys; mean age, 12.5 years; SD, 2.6 years) had WC measured at 4 sites: iliac crest (WC1), narrowest waist (WC2), midpoint between the floating rib and iliac crest (WC3), and umbilicus (WC4). Height, weight, fasting insulin level, glucose level, cholesterol level, and systolic and diastolic blood pressure were also measured. RESULTS: Overall, WC1 (108.5 cm; SD, 16.3 cm) was greater than WC2 (97.4 cm; SD, 13.6 cm; P < .003), and WC2 was smaller than WC3 (104.3 cm; SD, 15.3 cm; P = .02) and WC4 (108.7 cm; SD, 16.2 cm; P < .0003). With logistic regression, WC2 and WC3 were revealed to be more consistently associated with metabolic syndrome by using 3 different definitions. CONCLUSION: In our sample, we observed differences in 4 commonly recommended WC measurement sites and found that all sites were not equivalently associated with metabolic risk. Our findings provide preliminary support suggesting that WC measured at the narrowest waist and midpoint between the floating rib and iliac crest may represent the measurement sites most closely associated with metabolic risk in overweight boys and girls.