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The Kulldorff circular spatial scan test for cases and the Chang-Rosychuk spatial scan test for events identified a statistically significant cluster of children's ED visits for asthma in the same DA (48112023) as the CFPP's location in the Wabamum area.
The Stone's test identified a statistically significant distance decline effect from both pollution sources, higher in the CFPP than in the IHA area.
The negative binomial multivariable models assessing the effects of distance provided evidence of a statistically significant inverse association with distance for the CFPP models (i.e., the smaller the distance the higher the estimated SMR (standardized morbidity rate) around the CFPP); for IHA, there was a significant positive association with distance, which means the estimated ratio increased as the distance increased from the IHA.
The models assessing the directional effect alone showed a strong positive coefficient for the longitude and a weaker negative coefficient for the latitude function for CFPP, which suggests that the dominant associations are towards the southeast from the CFPP.
After the effect of SES had been controlled for, the distance effect of CFPP remained inverse, but the directional effects remained only for the east direction (longitude in Table 3).
There was a small spatial autocorrelation in the model's residuals, as their Moran's coefficients were 0.109 and 0.110 (p < 0.001) for the CFPP and IHA models respectively.
Using a large, robust, linked and population-based administrative database covering a six-year period, this study found consistent increased risk of ED visits for asthma in children around the CFPP, located at the Wabamum area in the Edmonton metropolitan area during 2004-2010.
Despite the importance of CFPP as sources of major air pollutants there has never been an epidemiological study conducted in Canada examining the association of pollution from coal power plants with spatial distribution of adult or children's diseases.
The CFPP at Wabamum village is the largest of the six plants located in Alberta and represents the CFPP pollution source assessed in this study.
Circular spatial scan tests identified a cluster within the DA where the Wabamum CFPP is located and did not identify a cluster around IHA.
The crude multivariable model for CFPP suggests a directional effect towards the southeast in addition to the distance effect.
In addition, the predominant types of chemical emitted by the IHA (e.g., VOCs, PAHs) are lighter and therefore have a faster dispersion than the predominant chemicals emitted by the CFPP (e.g., S[O.sub.2]).