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Article

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

1
Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA
2
Department of Computer Science, University of California Los Angeles, Los Angeles, CA 90095, USA
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Health Effects Institute, Boston, MA 02110, USA
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Sonoma Technology, Inc., Petaluma, CA 94954, USA
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Mobilize Labs, University of California Los Angeles, Los Angeles, CA 90095, USA
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Department of Pediatrics, University of California Los Angeles, Los Angeles, CA 90095, USA
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Medical & Imaging Informatics Group, Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Ron Shadbegian, Juleen Lam and Linda T.M. Bui
Int. J. Environ. Res. Public Health 2022, 19(6), 3578; https://doi.org/10.3390/ijerph19063578
Received: 20 January 2022 / Revised: 5 March 2022 / Accepted: 11 March 2022 / Published: 17 March 2022
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 (PM2.5), relative humidity and temperature, geolocation (GPS), and asthma outcomes including lung function, medication use, and symptoms for 14 days. Hourly ambient (PM2.5, nitrogen dioxide (NO2), ozone (O3)) and traffic-related (nitrogen oxides (NOx) and PM2.5) 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 (FEV1) 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 FEV1 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 O3 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 FEV1 (−3.45 [−6.42, −0.47]). Daily (lag 0) exposure to traffic-related PM2.5 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 O3, NOx, and NO was significantly associated with increased rescue inhaler use (rate ratio [95% CI]: O3 1.52 [1.02, 2.27], NOx 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. View Full-Text
Keywords: personal air pollution; pediatric asthma; sensors; GPS; mobile health; PRISMS personal air pollution; pediatric asthma; sensors; GPS; mobile health; PRISMS
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Figure 1

MDPI and ACS Style

Hao, H.; Eckel, S.P.; Hosseini, A.; Van Vliet, E.D.S.; Dzubur, E.; Dunton, G.; Chang, S.Y.; Craig, K.; Rocchio, R.; Bastain, T.; Gilliland, F.; Okelo, S.; Ross, M.K.; Sarrafzadeh, M.; Bui, A.A.T.; Habre, R. Daily Associations of Air Pollution and Pediatric Asthma Risk Using the Biomedical REAI-Time Health Evaluation (BREATHE) Kit. Int. J. Environ. Res. Public Health 2022, 19, 3578. https://doi.org/10.3390/ijerph19063578

AMA Style

Hao H, Eckel SP, Hosseini A, Van Vliet EDS, Dzubur E, Dunton G, Chang SY, Craig K, Rocchio R, Bastain T, Gilliland F, Okelo S, Ross MK, Sarrafzadeh M, Bui AAT, Habre R. Daily Associations of Air Pollution and Pediatric Asthma Risk Using the Biomedical REAI-Time Health Evaluation (BREATHE) Kit. International Journal of Environmental Research and Public Health. 2022; 19(6):3578. https://doi.org/10.3390/ijerph19063578

Chicago/Turabian Style

Hao, Hua, Sandrah P. Eckel, Anahita Hosseini, Eleanne D.S. Van Vliet, Eldin Dzubur, Genevieve Dunton, Shih Y. Chang, Kenneth Craig, Rose Rocchio, Theresa Bastain, Frank Gilliland, Sande Okelo, Mindy K. Ross, Majid Sarrafzadeh, Alex A.T. Bui, and Rima Habre. 2022. "Daily Associations of Air Pollution and Pediatric Asthma Risk Using the Biomedical REAI-Time Health Evaluation (BREATHE) Kit" International Journal of Environmental Research and Public Health 19, no. 6: 3578. https://doi.org/10.3390/ijerph19063578

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