Gary L. Euler


To assess risk of chronic respiratory disease symptoms due to long-term exposure to the ambient levels of TSP, oxidants, SO2 and NO2 in photochemical air pollution, symptoms were ascertained using NHLBI questions on 8,572 Southern California Seventh-day Adventist, nonsmokers, 25 years and older, who lived eleven years or longer in their 1977 residential area. Tobacco smoke, active and passive, and occupational exposures were measured by questionnaires, as well as lifestyle characteristics relative to pollution exposure such as time spent outside and residence history. A pulmonary function feasibility study was done on a subsample of 86 women 50-64 years of age stratified into four subgroups by high/low cumulative pollution exposure and by questionnaire ascertained symptoms of chronic obstructive pulmonary disease (COPD). This sub study did demonstrate the feasibility of pulmonary function testing and did validate residence history ascertainment, however, it failed to validate either employment history assessment or the questionnaire algorithm diagnosis of COPD. For each of the 7336 participants who responded and qualified for analysis, cumulative exposures to each pollutant In excess of four thresholds were estimated using monthly residence zip code histories and interpolated dosages from state air-monitory stations. Multiple logistic regression analyses were conducted for pollutants individually and together with eight covariables including passive smoking at home and at work, past smoking, occupational exposure, sex, age, race, and education. Statistically significant associations with chronic symptoms were seen for 1) SO2 exposure above 4 pphm, (p = 0.03); relative risk 1.18 for 13% of the study population with 500 hrs/yr of exposure, 2) oxidants above 10 pphm, p < 0.004; relative risk of 1.20 for 18% with 750 hrs/yr, and 3) TSP above 200 mcg/m3, (p < 0.00001); relative risk of 1.22 for 25% with 750 hrs/yr. When these pollutant exposures were entered together TSP was the only one showing statistical significance. (p < 0.01). NO2 exposure levels in this population were not linked to chronic respiratory disease symptoms. Individuals working with smokers for 10 years had relative risks of 1.11 and those living with a smoker for 10 years had relative risks of 1.07. In conclusion, photochemical air pollution exposure seems to produce about twice the risk of chronic symptoms of respiratory disease as working with a smoker and about three times the risk as living with a smoker In nonsmoking adults residing for at least eleven years at the top quintile of Southern California residential ambient photochemical air pollution as measured by cumulative exceedance hours above the most significant threshold concentrations studied. Exposure to total suspended particulates above 200 ug/m3 is more strongly linked to chronic respiratory disease symptoms than exposure to any other single pollutant/threshold studied. Methods utilized here may result in better assessment and development of air quality standards in the future.

LLU Discipline



Epidemiology and Biostatistics


School of Health

First Advisor

David E. Abbey

Second Advisor

John E. Hodgkin

Third Advisor

Allan R. Magie

Fourth Advisor

Paul Yahiku

Fifth Advisor

Gary Fraser

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Respiratory Tract Diseases -- etiology; Tobacco Smoke Pollution -- adverse effects; Air Pollutants; Environmental -- adverse effects



Page Count

3 v. : ill; 850

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives