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Volume 17
Issue 6
10.3390/atmos17060534
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Air Quality and Emergency Department Visits for Pediatric Respiratory Outcomes in Fresno County, California, USA

by
Kimberly Valle
1,
Kate DeMarsh
2,
Estrella Herrera
1,
Tim Tyner
3,
Derek Payton
3,
Stephanie Koch-Kumar
4,
Mayra Lemus Rangel
5,
Jermaine Reece
6,
Sandie Ha
1,7,
Sidra Goldman-Mellor
1,7,
Trevor P. Hirst
7,
Matt Holmes
8,
Adriana Espinosa
1,
Asa Bradman
1,7 and
Alec M. Chan-Golston
1,7,*
1
Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA 95343, USA
2
Department of Life and Environmental Sciences, School of Engineering, University of California, Merced, Merced, CA 95343, USA
3
Central California Asthma Collaborative, Fresno, CA 93727, USA
4
Division of Epidemiology, Surveillance, & Data Management, Fresno County Department of Public Health, Fresno, CA 93721, USA
5
Valley Children’s Hospital, Madera, CA 93636, USA
6
Stockton Unified School District, Stockton, CA 95206, USA
7
Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA
8
Valley Improvement Projects, Modesto, CA 95352, USA
*
Author to whom correspondence should be addressed.
Atmosphere 2026, 17(6), 534; https://doi.org/10.3390/atmos17060534
Submission received: 9 December 2025 / Revised: 15 May 2026 / Accepted: 20 May 2026 / Published: 22 May 2026
(This article belongs to the Section Air Quality and Health)
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Abstract

Air quality in the San Joaquin Valley (SJV) ranks among the worst in the US. Exposures to traffic-related air pollutants have been associated with pediatric health complications, and few studies have investigated respiratory complications in relation to short-term exposures to PM less than 2.5 microns in diameter (PM2.5) in the SJV. We used Bayesian Poisson spatiotemporal conditional autoregressive models to analyze the association between PM2.5 and pediatric respiratory emergency department (ED) visits in Fresno County, California. Additional analyses stratified respiratory outcomes by sex and age group. Weekly ambient PM2.5 levels were estimated for each zip code using community science and regulatory air monitors. Weekly residential zip code counts of respiratory ED visits were provided by Fresno County Department of Public Health and Valley Children’s Hospital from 2 April 2022 to 31 December 2024. A ten-fold increase in PM2.5 was associated with increased asthma ED visits among females (Relative Risk (RR):1.15; 95% Credible Interval (CrI):1.01, 1.32) and children aged 0 to 4 (RR:1.18; 95% CrI:1.03, 1.34) and other chronic respiratory conditions among males (RR:1.93; 95% CrI:1.19, 3.16) and ages 10 to 14 (RR:2.90; 95% CrI:1.32, 6.30). Findings suggest that efforts to better assess and reduce pollution exposures will improve public health in the SJV.
Keywords: air quality; children’s health; asthma; emergency departments; San Joaquin Valley; ICD-10; particulate matter 2.5 air quality; children’s health; asthma; emergency departments; San Joaquin Valley; ICD-10; particulate matter 2.5
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MDPI and ACS Style

Valle, K.; DeMarsh, K.; Herrera, E.; Tyner, T.; Payton, D.; Koch-Kumar, S.; Lemus Rangel, M.; Reece, J.; Ha, S.; Goldman-Mellor, S.; et al. Air Quality and Emergency Department Visits for Pediatric Respiratory Outcomes in Fresno County, California, USA. Atmosphere 2026, 17, 534. https://doi.org/10.3390/atmos17060534

AMA Style

Valle K, DeMarsh K, Herrera E, Tyner T, Payton D, Koch-Kumar S, Lemus Rangel M, Reece J, Ha S, Goldman-Mellor S, et al. Air Quality and Emergency Department Visits for Pediatric Respiratory Outcomes in Fresno County, California, USA. Atmosphere. 2026; 17(6):534. https://doi.org/10.3390/atmos17060534

Chicago/Turabian Style

Valle, Kimberly, Kate DeMarsh, Estrella Herrera, Tim Tyner, Derek Payton, Stephanie Koch-Kumar, Mayra Lemus Rangel, Jermaine Reece, Sandie Ha, Sidra Goldman-Mellor, and et al. 2026. "Air Quality and Emergency Department Visits for Pediatric Respiratory Outcomes in Fresno County, California, USA" Atmosphere 17, no. 6: 534. https://doi.org/10.3390/atmos17060534

APA Style

Valle, K., DeMarsh, K., Herrera, E., Tyner, T., Payton, D., Koch-Kumar, S., Lemus Rangel, M., Reece, J., Ha, S., Goldman-Mellor, S., Hirst, T. P., Holmes, M., Espinosa, A., Bradman, A., & Chan-Golston, A. M. (2026). Air Quality and Emergency Department Visits for Pediatric Respiratory Outcomes in Fresno County, California, USA. Atmosphere, 17(6), 534. https://doi.org/10.3390/atmos17060534

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