The importance of toxicity in determining the impact of hazardous air pollutants on the respiratory health of children in Tennessee

•High total HAP emissions does not necessarily mean high toxicity emissions.•Acute bronchitis is more related to total emissions than toxicity.•Most respiratory illness discharges are associated with asthma.•Toxicity is significantly more related to asthma than total emissions.•Poverty is more closely associated with respiratory illness than is race.

Respiratory diseases, exacerbated through point source pollution, are currently among the leading causes of hospitalization of children in the United States. This paper investigates the relationship between the proximity of hazardous air pollutants (HAPs) emitted from Toxic Release Inventory (TRI) facilities and the number of children diagnosed in hospitals with a respiratory disease in Tennessee. The importance of controlling for toxicity of those HAPs is of particular interest. Hospital discharge, socioeconomic, TRI emission, and HAP toxicity data are used to estimate, via Generalized Linear Methods, a logistic regression model describing the relationship between the percent of children living in a zip code area treated for respiratory illness and the average annual emissions over the previous 10 years of HAPs from TRI sites in that area. Controlling for area socioeconomic characteristics, we find that accounting for toxicity is important in uncovering the relationship between HAP emissions and respiratory health of children. A one standard deviation increase in toxicity-weighted emissions per 100 square miles is associated with an increase in the number of children diagnosed with asthma (chronic bronchitis) by about 1205 (260). The evidence suggests that, with a goal to improving children's respiratory health, monitoring the toxicity of chemicals being emitted is at least as important as simply monitoring total emission levels. This suggests that the EPA should consider making efforts toward establishing toxicity adjusted emission guidelines.

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