Daily Associations of Air Pollution and Pediatric Asthma Risk Using the Biomedical REAI-Time Health Evaluation (BREATHE) Kit

Hua Hao, Sandrah P. Eckel, Anahita Hosseini, Eleanne D. S. Van Vliet, Eldin Dzubur, Genevieve Dunton, Shih Ying Chang, Kenneth Craig, Rose Rocchio, Theresa Bastain, Frank Gilliland, Sande Okelo, Mindy K. Ross, Majid Sarrafzadeh, Alex A. T. Bui and Rima Habre
Additional contact information
Hua Hao: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Sandrah P. Eckel: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Anahita Hosseini: Department of Computer Science, University of California Los Angeles, Los Angeles, CA 90095, USA
Eleanne D. S. Van Vliet: Health Effects Institute, Boston, MA 02110, USA
Eldin Dzubur: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Genevieve Dunton: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Shih Ying Chang: Sonoma Technology, Inc., Petaluma, CA 94954, USA
Kenneth Craig: Sonoma Technology, Inc., Petaluma, CA 94954, USA
Rose Rocchio: Mobilize Labs, University of California Los Angeles, Los Angeles, CA 90095, USA
Theresa Bastain: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Frank Gilliland: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
Sande Okelo: Department of Pediatrics, University of California Los Angeles, Los Angeles, CA 90095, USA
Mindy K. Ross: Department of Pediatrics, University of California Los Angeles, Los Angeles, CA 90095, USA
Majid Sarrafzadeh: Department of Computer Science, University of California Los Angeles, Los Angeles, CA 90095, USA
Alex A. T. Bui: Medical & Imaging Informatics Group, Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
Rima Habre: Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA

IJERPH, 2022, vol. 19, issue 6, 1-17

Abstract: Background: Exposure to air pollution is associated with acute pediatric asthma exacerbations, including reduced lung function, rescue medication usage, and increased symptoms; however, most studies are limited in investigating longitudinal changes in these acute effects. This study aims to investigate the effects of daily air pollution exposure on acute pediatric asthma exacerbation risk using a repeated-measures design. Methods: We conducted a panel study of 40 children aged 8–16 years with moderate-to-severe asthma. We deployed the Biomedical REAI-Time Health Evaluation (BREATHE) Kit developed in the Los Angeles PRISMS Center to continuously monitor personal exposure to particulate matter of aerodynamic diameter < 2.5 µm (PM 2.5 ), relative humidity and temperature, geolocation (GPS), and asthma outcomes including lung function, medication use, and symptoms for 14 days. Hourly ambient (PM 2.5 , nitrogen dioxide (NO 2 ), ozone (O 3 )) and traffic-related (nitrogen oxides (NO x ) and PM 2.5 ) air pollution exposures were modeled based on location. We used mixed-effects models to examine the association of same day and lagged (up to 2 days) exposures with daily changes in % predicted forced expiratory volume in 1 s (FEV 1 ) and % predicted peak expiratory flow (PEF), count of rescue inhaler puffs, and symptoms. Results: Participants were on average 12.0 years old (range: 8.4–16.8) with mean (SD) morning %predicted FEV 1 of 67.9% (17.3%) and PEF of 69.1% (18.4%) and 1.4 (3.5) puffs per day of rescue inhaler use. Participants reported chest tightness, wheeze, trouble breathing, and cough symptoms on 36.4%, 17.5%, 32.3%, and 42.9%, respectively ( n = 217 person-days). One SD increase in previous day O 3 exposure was associated with reduced morning (beta [95% CI]: −4.11 [−6.86, −1.36]), evening (−2.65 [−5.19, −0.10]) and daily average %predicted FEV 1 (−3.45 [−6.42, −0.47]). Daily (lag 0) exposure to traffic-related PM 2.5 exposure was associated with reduced morning %predicted PEF (−3.97 [−7.69, −0.26]) and greater odds of “feeling scared of trouble breathing” symptom (odds ratio [95% CI]: 1.83 [1.03, 3.24]). Exposure to ambient O 3 , NO x , and NO was significantly associated with increased rescue inhaler use (rate ratio [95% CI]: O 3 1.52 [1.02, 2.27], NO x 1.61 [1.23, 2.11], NO 1.80 [1.37, 2.35]). Conclusions: We found significant associations of air pollution exposure with lung function, rescue inhaler use, and “feeling scared of trouble breathing.” Our study demonstrates the potential of informatics and wearable sensor technologies at collecting highly resolved, contextual, and personal exposure data for understanding acute pediatric asthma triggers.

Keywords: personal air pollution; pediatric asthma; sensors; GPS; mobile health; PRISMS (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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