BACKGROUND: Acrolein is an air toxic and tobacco smoke toxicant that laboratory studies suggest may adversely affect pulmonary function. There is strikingly little epidemiology available, however, even though US EPA's 2005 National-Scale Air Toxics Assessment (NATA) estimates that acrolein is responsible for about 75 percent of non-cancer respiratory health effects attributable to air toxics in the United States. AIMS: Characterize the association between model-estimated outdoor acrolein exposure and the prevalence of self-reported COPD. METHODS: Sample-weighted statistical analysis characterized the association between self-reported doctor-diagnosed COPD ("emphysema") and NATA acrolein exposure estimates at the census tract geographically linked to residences of subjects ≥55-years-old in the National Health Interview Survey (NHIS) 2000 - 2009 (n = 89,475). RESULTS: Preliminary results indicate that among never smokers and never & former smokers, outdoor acrolein exposure (1.38E-4 to 4.57E-1 ug/m3) was not associated with COPD prevalence at a statistically significant level, controlling for potential confounders. CONCLUSIONS: Outdoor acrolein exposure is unrelated to COPD prevalence in a nationally representative sample of United States adults 55 and over.

1. Acrolein and COPD in a nationally representative sample
of United States adults 55 and over
B. Rey deCastro; CDC National Center for Environmental Health, Atlanta, GA, United States
National Center for Environmental Health
Division of Laboratory SciencesEmail: cdcinfo@cdc.gov | Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not
necessarily represent the official position of the Centers for Disease Control and Prevention.
Introduction
•Acrolein is an air toxic and tobacco smoke
toxicant that is a potent irritant of respiratory
tissue
•General difficulties with ambient measurement
have prevented epidemiologic evaluation
•US EPA's 2005 National-Scale Air Toxics
Assessment (NATA) nevertheless estimates that
acrolein is responsible for about 75 percent of
non-cancer respiratory health effects attributable
to air toxics in the United States
Results
•Among adults ≥55-years-old, outdoor exposure to acrolein ≥1.09E-2 g/m3 was associated
with a statistically significant reduction in COPD prevalence compared to the lowest
exposure quintile, controlling for smoking status and other potential confounders
•Among never smokers ≥55-years-old, outdoor exposure to acrolein ≥3.40E-2 g/m3 was
associated with a non-significant increase in COPD prevalence, controlling for potential
confounders
•Large sample
•National geographic coverage
•Census tract resolution
•Generalizable to civilian, non-institutionalized population of the United States 55 years-old
and over
•Uncertainty of NATA exposure estimates
•NATA more appropriate for identifying air pollutants with higher health risks, and less
appropriate for estimating absolute risk levels
•Potential acrolein exposure from indoor air, food unaccounted for
•NATA does not estimate short-term peak exposures to acrolein
Materials & Methods
•NATA acrolein exposure concentration estimates
were geographically linked to subjects ≥55-years-
old in the National Health Interview Survey
(NHIS) 2000 - 2009 (n = 89,475), and stratified
for never smokers (n = 44,802)
•Sample-weighted logistic regression model
estimated the association between COPD
(emphysema) diagnosis and acrolein exposure
concentration quintile
•Potential confounders: sex; age; race/ethnicity;
smoking status; education; poverty income ratio
(multiply imputed); NHIS survey year; access to
healthcare; insurance coverage
Conclusions
•At acrolein concentrations likely to be encountered outdoors in the United States, exposure
was not associated with a statistically significant increase in prevalence of COPD diagnoses
in a sample representative of the civilian, non-institutionalized population of the United
States ≥55-years-old
•Among never smokers ≥55-years-old, there was an apparent, but statistically non-significant,
increase in prevalence of COPD diagnoses at outdoor acrolein exposure concentrations
≥3.40E-2 g/m3
Literature Cited
•ATSDR. 2007. Toxicological Profile for Acrolein. Atlanta, GA
•CDC. 2000-2009. National Health Interview Survey. Available:
http://www.cdc.gov/nchs/nhis.htm
•US EPA. 2003a. Toxicological Review of Acrolein. EPA/635/R-03/003.
Washington, DC
•US EPA. 2003b. Integrated Risk Information System (IRIS) on Acrolein.
Available: http://www.epa.gov/iris/subst/0364.htm
•US EPA. 2011. 2005 National-scale Air Toxics Assessment Results.
Available: http://www.epa.gov/ttn/atw/nata2005/
Acknowledgements
The author would like to thank Jennifer Parker (NCHS) for her crucial
help and insightful suggestions for improving this analysis. The author
is also indebted to Lara Akinbami, Phillip Kott, Nataliya Kravets, Erik
Olson, and Ted Palma
Further Information
rdecastro@cdc.gov, +1 770-488-0162, CDC NCEH, 4770 Buford Hwy,
Mailstop F 47, Atlanta GA 30341-3717
Contact
Merge by
Census
Tract
NATA
Acrolein
Exposure
NHIS
Adult
COPD
Merged
NATA-
NHIS
Data
Strengths
Limitations
All Never Smokers
[μg/m3] Quintile [μg/m3] pOR [95% CI] pOR [95% CI]
1st: 1.38E-4 – 1.09E-2 Ref. Ref.
US EPA RfC: 2.00E-2 2nd: 1.09E-2 – 2.14E-2 0.89 [0.79:1.00] 0.88 [0.64:1.23]
3rd: 2.14E-2 – 3.40E-2 0.80 [0.71:0.91] 0.88 [0.64:1.21]
CA REL: 3.50E-1 4th: 3.40E-2 – 5.51E-2 0.88 [0.77:1.00] 1.16 [0.77:1.72]
5th: 5.51E-2 – 4.57E-1 0.84 [0.72:0.98] 1.21 [0.85:1.73]
All Never Smokers
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