{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:21:56Z","timestamp":1767374516727,"version":"3.48.0"},"reference-count":38,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ken and Eva Smith Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,5,30]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall\u2019s \u03c4 correlation and multivariable Poisson regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with 2+ asthma encounters during the EPA study timeframe were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Residential distance from railyards exhibited a significant negative correlation with overall (\u22120.36 (CI \u22120.41 to \u20130.32)) and acute (\u22120.27 (CI \u22120.32 to \u20130.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3\u2009km was associated with a decrease in overall asthma rates of 26%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080915","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T14:15:19Z","timestamp":1721225719000},"page":"e080915","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing environmental injustice in Kansas City by linking paediatric asthma to local sources of pollution: a cross-sectional study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-635X","authenticated-orcid":false,"given":"Elizabeth","family":"Friedman","sequence":"first","affiliation":[{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA"},{"name":"Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian R","family":"Lee","sequence":"additional","affiliation":[{"name":"Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rahn","sequence":"additional","affiliation":[{"name":"University of Kansas College of Liberal Arts and Sciences, Lawrence, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beto","family":"Lugo Martinez","sequence":"additional","affiliation":[{"name":"RISE4EJ, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atenas","family":"Mena","sequence":"additional","affiliation":[{"name":"Vibrant Health, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"2025121400092062000_14.7.e080915.1","doi-asserted-by":"crossref","first-page":"A204","DOI":"10.1289\/ehp.114-a204","article-title":"Guest editorial: ships, trucks, and trains: effects of goods movement on environmental health","volume":"114","author":"Hricko","year":"2006","journal-title":"Environ Health Perspect"},{"key":"2025121400092062000_14.7.e080915.2","unstructured":"Lugo-Martinez B , Reed G , Kalman C . Environmental racism in the heartland fighting for equity and health in Kansas City. 2021."},{"key":"2025121400092062000_14.7.e080915.3","unstructured":"Inman R . Kansas City, Mo., is one of America\u2019s top rail hubs. Trains.com, 2021. Available: https:\/\/www.trains.com\/trn\/videos-photos\/photos\/photo-galleries\/kansas-city-mo-is-one-of-americas-top-rail-hubs\/ [Accessed 16 Jul 2023]."},{"key":"2025121400092062000_14.7.e080915.4","first-page":"1","article-title":"Combining dispersion modeling and monitoring data for community-scale air quality characterization","volume":"10","author":"Isakov","year":"2019","journal-title":"Atmosphere (Basel)"},{"key":"2025121400092062000_14.7.e080915.5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/chemosensors7020026","article-title":"The Kansas City transportation and local-scale air quality study (KC-TRAQS): integration of low-cost sensors and reference grade monitoring in a complex metropolitan area. part 1: overview of the project","volume":"7","author":"Kimbrough","year":"2019","journal-title":"Chemosensors (Basel)"},{"key":"2025121400092062000_14.7.e080915.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32345-0"},{"key":"2025121400092062000_14.7.e080915.7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7004a1"},{"key":"2025121400092062000_14.7.e080915.8","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6705e1"},{"key":"2025121400092062000_14.7.e080915.9","doi-asserted-by":"crossref","DOI":"10.1016\/j.healthplace.2022.102927","article-title":"Historic racism in Kansas City affects today\u2019s pediatric asthma burden","volume":"78","author":"Friedman","year":"2022","journal-title":"Health Place"},{"key":"2025121400092062000_14.7.e080915.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025121400092062000_14.7.e080915.11","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.10735"},{"key":"2025121400092062000_14.7.e080915.12","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s10900-015-0026-0","article-title":"Respiratory health risks for children living near a major railyard","volume":"40","author":"Spencer-Hwang","year":"2015","journal-title":"J Community Health"},{"key":"2025121400092062000_14.7.e080915.13","unstructured":"US Environmental Protection Agency . Toxics release inventory (TRI) program. 2022. 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Boston, MA; Systematic Review and Meta-analysis of Selected Health Effects of Long-Term Exposure to Traffic-Related Air Pollution, 2022. 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Cicero rail yard study (CIRYS) final report 2014. 2014. 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