Prediction of asthma exacerbations among children through integrating air pollution, upper atmosphere, and school health surveillances

Abstract

Climatic factors and air pollution are important in predicting asthma exacerbations among children. This study was designed to determine if a relationship exists between asthma exacerbations among elementary school children and the combined effect of daily upper atmosphere observations (temperature, relative humidity, dew point, and mixing ratio) and daily air pollution (particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone) and, if so, to predict asthma exacerbations among children using a mathematical model. Using an ecological study design, school health records of 168,825 students in elementary schools enrolled in "Health eTools for Schools" within 49 Pennsylvania counties were analyzed. Data representing asthma exacerbations were originally recorded by school nurses as the type of treatment given to a student during a clinic visit on a particular day. Daily upper atmosphere measurements from ground level to the 850-mb pressure level and air pollution measurements were obtained. A generalized estimating equation model was used to predict the occurrence of >48 asthma exacerbations, the daily mean for 2008-2010. The greatest occurrence of asthma among school children was in the fall, followed by summer, spring, and winter. Upper atmosphere temperature, dew point, mixing ratio, and six air pollutants as well as their interactions predicted the probability of asthma exacerbations occurring among children. Monitoring of upper atmosphere observation data and air pollutants over time can be a reliable means for predicting increases of asthma exacerbations among elementary school children. Such predictions could help parents and school officials implement effective precautionary measures.

A comparison of seasonal trends in asthma exacerbations among children from geographic regions with different climates

“…24 -26 Although these factors may be less likely to vary seasonally in parallel with seasonal peaks of asthma exacerbations, climate factors and air pollution have been reported to have value in predicting asthma symptoms among elementary school children. 27 Challenges to consider in interpreting the results from this study included the selection of three regions in the United States with different climates. A more comprehensive study that includes other regions (e.g., the Midwest and Northwest) would be of interest and also larger in scope.…”

Fine particulate matter (PM2.5) enhances allergic sensitization in BALB/cmice

“…There are two hallmark phenotypes of allergic asthma: (1) inflammatory, due to a T helper cell type 2 (Th2)-mediated immune response resulting in elevated inflammatory cells in the airways, and (2) airway hyper-reactivity, during which volume and flow of inhaled air decreases as a consequence of airway constriction. Numerous epidemiological studies demonstrated an association of increased asthma prevalence and exacerbation of symptoms with exposure to ambient air pollutants (McConnell et al 2006; von Klot et al 2002; Kim and Bernstein 2009; Jayawardene et al 2013; Cheng et al 2014; Chen et al, 2016; Greenberg et al, 2016). …”

Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

“…There are publicly available data on air quality from the air monitoring stations, such as the air quality index from the Environment Protection Agency, which provides information on level of specific pollutants such as O 3 , sulfur dioxide or NO 2 by geographic area. Future studies integrating such local monitoring environmental data [37,38] with patients’ geospatial information such as residential address, may be helpful to validate the accuracy of self-reported air pollution/irritants as trigger.…”