Respiratory hospitalizations of children living near a hazardous industrial site adjusted for prevalent dust: A case–control study

The Neot Hovav Industrial Park (IP), located in southern Israel, hosts 23 chemical industry facilities and the national site for treatment of hazardous waste. Yet, information about its impact on the health of local population has been mostly ecological, focused on Bedouins and did not control for possible confounding effect of prevalent dust storms. This case–control study examined whether living near the IP could lead to increased risk of pediatric hospitalization for respiratory diseases. Cases (n = 3608) were residents of the Be'er Sheva sub-district aged 0–14 years who were admitted for respiratory illnesses between 2004 and 2009. These were compared to children admitted for non-respiratory conditions (n = 3058). Home addresses were geocoded and the distances from the IP to the child's residence were calculated. The association between hospitalization and residential distance from the IP was examined for three age groups (0–1, 2–6, 7–14) by logistic regressions adjusting for gender, socioeconomic status, urbanity and temperature. We found that infants in the first year of life who lived within 10 km of the IP had increased risk of respiratory hospitalization when compared with those living >20 km from the IP (adjusted odds ratio, OR = 2.07, 95% confidence interval, CI: 1.19–3.59). In models with both distance from the IP and particulate matter with aerodynamic diameter <10 μm (PM₁₀) the estimated risk was modestly attenuated (OR = 1.96, 95% CI: 1.09–3.51). Elevated risk was also observed for children 2–5 years of age but with no statistical significance (OR = 1.16, 95% CI: 0.76–1.76). Our findings suggest that residential proximity to a hazardous industrial site may contribute to early life respiratory admissions, beyond that of prevailing PM₁₀.