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Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Research article

Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study

Authors: Austin R. Waters, Echo L. Warner, Perla L. Vaca Lopez, Anne C. Kirchhoff, Judy Y. Ou

Published in: BMC Cancer | Issue 1/2021

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Abstract

Background

Emerging research suggests that survivors of childhood and adolescent cancers are at risk for morbidity and mortality associated with air pollutants. However, caregiver perceptions of the effects of air pollution are unknown. Thus, to address this gap we described caregivers’ perceptions of air pollution’s impact on general population health and specifically on childhood cancer survivors, and caregivers’ air pollution information-seeking and exposure reduction behaviors.

Methods

Participants were Utah residents, ≥18 years, and caregiver of a childhood cancer survivor who had completed treatment. Semi-structured interviews were conducted with caregivers to describe their perspectives on air quality, how air pollution impacts health (general population and survivor health), and their information seeking and exposure reduction behaviors. Interviews were recorded, transcribed, and analyzed through two rounds of structured coding.

Results

Caregivers (N = 13) were non-Hispanic white and primarily females (92.3%) between 30 and 49 years old (46.2%). Most families lived within the Wasatch Front (69.2%), the main metropolitan of Utah. Two categories emerged pertaining to caregiver’s perceptions of air pollution: 1) Limited awareness about the health effects of air pollution, and 2) Unsuccessful information seeking and minimal exposure reduction behaviors. All caregivers held negative perceptions of air pollution in Utah, but most were unaware of how pollution affects health. While some families limited air pollution exposure by avoiding outdoor activity or physically leaving the region, few practiced survivor-specific exposure reduction. Nearly half of caregivers worried about potential effects of air pollution on survivor health and wanted more information.

Conclusions

Despite negative perceptions of air pollution, caregivers were divided on whether air pollution could impact survivor health. Few caregivers engaged in exposure reduction for their cancer survivor. As air pollution levels increase in the U.S., continued research on this topic is essential to managing cancer survivor respiratory and cardiovascular health.
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Literature
1.
go back to reference American Cancer Society. Cancer Treatment & Survivorship Facts & figures 2019–2021. Atlanta: American Cancer Society; 2019. American Cancer Society. Cancer Treatment & Survivorship Facts & figures 2019–2021. Atlanta: American Cancer Society; 2019.
5.
go back to reference Cupit-Link MC, Kirkland JL, Ness KK, Armstrong GT, Tchkonia T, LeBrasseur NK, et al. Biology of premature ageing in survivors of cancer. ESMO Open. 2017;2(5):e000250-e.CrossRef Cupit-Link MC, Kirkland JL, Ness KK, Armstrong GT, Tchkonia T, LeBrasseur NK, et al. Biology of premature ageing in survivors of cancer. ESMO Open. 2017;2(5):e000250-e.CrossRef
7.
go back to reference Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, et al. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev. 2020;29(10):1929–39.CrossRef Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, et al. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev. 2020;29(10):1929–39.CrossRef
8.
go back to reference Turner MC, Krewski D, Diver WR, Pope CA 3rd, Burnett RT, Jerrett M, et al. Ambient Air Pollution and Cancer Mortality in the Cancer Prevention Study II. Environ Health Perspect. 2017;125(8):087013.CrossRef Turner MC, Krewski D, Diver WR, Pope CA 3rd, Burnett RT, Jerrett M, et al. Ambient Air Pollution and Cancer Mortality in the Cancer Prevention Study II. Environ Health Perspect. 2017;125(8):087013.CrossRef
9.
go back to reference Goldberg MS, Bailar JC III, Burnett RT, Brook JR, Tamblyn R, Bonvalot Y, et al. Identifying subgroups of the GeneralPopulation that may be susceptible toShort-term increases in particulate AirPollution: a time-series study inMontreal. Quebec Quebec: Health Effects Institute; 2000. Goldberg MS, Bailar JC III, Burnett RT, Brook JR, Tamblyn R, Bonvalot Y, et al. Identifying subgroups of the GeneralPopulation that may be susceptible toShort-term increases in particulate AirPollution: a time-series study inMontreal. Quebec Quebec: Health Effects Institute; 2000.
12.
go back to reference Ou JY, Hanson HA, Ramsay JM, Leiser CL, Zhang Y, VanDerslice JA, et al. Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers. Int J Environ Res Public Health. 2019;16(6):1081.CrossRef Ou JY, Hanson HA, Ramsay JM, Leiser CL, Zhang Y, VanDerslice JA, et al. Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers. Int J Environ Res Public Health. 2019;16(6):1081.CrossRef
13.
go back to reference The American Lung Association. State of the air 2021. Chicago: The American Long Association; 2021. The American Lung Association. State of the air 2021. Chicago: The American Long Association; 2021.
14.
go back to reference Clay K, Muller NZ. Recent Increases in Air Pollution: Evidence and Implications for Mortality, National Bureau of Economic Research Working Paper Series; 2019. p. 26381.CrossRef Clay K, Muller NZ. Recent Increases in Air Pollution: Evidence and Implications for Mortality, National Bureau of Economic Research Working Paper Series; 2019. p. 26381.CrossRef
17.
go back to reference Xie Y, Lin M, Horowitz LW. Summer PM2.5 Pollution Extremes Caused by Wildfires Over the Western United States During 2017–2018. Geophys Res Lett. 2020;47(16):e2020GL089429.CrossRef Xie Y, Lin M, Horowitz LW. Summer PM2.5 Pollution Extremes Caused by Wildfires Over the Western United States During 2017–2018. Geophys Res Lett. 2020;47(16):e2020GL089429.CrossRef
18.
go back to reference Ou JY, Hanson HA, Ramsay JM, Leiser CL, Zhang Y, Van Derslice J, et al. Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers. Int J Environ Res Public Health. 2019;16(6):1081. Ou JY, Hanson HA, Ramsay JM, Leiser CL, Zhang Y, Van Derslice J, et al. Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers. Int J Environ Res Public Health. 2019;16(6):1081.
19.
go back to reference Gillies RR, Wang S, Booth MR. Atmospheric scale interaction on wintertime intermountain west low-level inversions. Atmos Environ. 2010;25(4):1196-210. Gillies RR, Wang S, Booth MR. Atmospheric scale interaction on wintertime intermountain west low-level inversions. Atmos Environ. 2010;25(4):1196-210.
20.
go back to reference Harris E. State and county population estimates for Utah: 2019. Kem C: Gardner Policy Institute, The University of Utah; 2019. Harris E. State and county population estimates for Utah: 2019. Kem C: Gardner Policy Institute, The University of Utah; 2019.
24.
go back to reference Saldaña J. The coding manual for qualitative researchers. Second edition ed. Los Angeles: SAGE Publications Ltd; 2013. p. 328. Saldaña J. The coding manual for qualitative researchers. Second edition ed. Los Angeles: SAGE Publications Ltd; 2013. p. 328.
25.
go back to reference McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22(3):276–82.CrossRef McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22(3):276–82.CrossRef
28.
go back to reference Slovic P, Weber EU. Perception of risk posed by extreme events. Applegate JS, Gabba JM, Laitos JG, Sachs N, editors. California: Foundation Press; 2013. Slovic P, Weber EU. Perception of risk posed by extreme events. Applegate JS, Gabba JM, Laitos JG, Sachs N, editors. California: Foundation Press; 2013.
30.
go back to reference Shin M, Werner KA, Strosnider H, Hines BL, Balluz L, Yip YF. Public Perceptions of Environmental Public Health Risks in the United States. Int J Environ Res Public Health. 2019;16(6):1045. Shin M, Werner KA, Strosnider H, Hines BL, Balluz L, Yip YF. Public Perceptions of Environmental Public Health Risks in the United States. Int J Environ Res Public Health. 2019;16(6):1045.
32.
go back to reference Greenzang KA, Cronin AM, Kang T, Mack JW. Parent understanding of the risk of future limitations secondary to pediatric cancer treatment. Pediatric Blood Cancer. 2018;65(7):e27020-e.CrossRef Greenzang KA, Cronin AM, Kang T, Mack JW. Parent understanding of the risk of future limitations secondary to pediatric cancer treatment. Pediatric Blood Cancer. 2018;65(7):e27020-e.CrossRef
35.
go back to reference Castner J, Amiri A, Rodriguez J, Huntington-Moskos L, Thompson LM, Zhao S, et al. Advancing the symptom science model with environmental health. Public health nursing (Boston, Mass). 2019;36(5):716–25.CrossRef Castner J, Amiri A, Rodriguez J, Huntington-Moskos L, Thompson LM, Zhao S, et al. Advancing the symptom science model with environmental health. Public health nursing (Boston, Mass). 2019;36(5):716–25.CrossRef
36.
go back to reference Chen S, Oliva P, Zhang P. The Effect of Air Pollution on Migration: Evidence from China, National Bureau of Economic Research Working Paper Series; 2017. p. 24036.CrossRef Chen S, Oliva P, Zhang P. The Effect of Air Pollution on Migration: Evidence from China, National Bureau of Economic Research Working Paper Series; 2017. p. 24036.CrossRef
37.
go back to reference Best H, Rüttenauer T. How selective migration shapes environmental inequality in Germany: evidence from Micro-level panel data. Eur Sociol Rev. 2017;34(1):52–63.CrossRef Best H, Rüttenauer T. How selective migration shapes environmental inequality in Germany: evidence from Micro-level panel data. Eur Sociol Rev. 2017;34(1):52–63.CrossRef
Metadata
Title
Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study
Authors
Austin R. Waters
Echo L. Warner
Perla L. Vaca Lopez
Anne C. Kirchhoff
Judy Y. Ou
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-08739-y

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