Search Results (6)

Background/Objectives: Asthma exacerbations are among the most frequent causes of pediatric emergency department (ED) visits, with over 700,000 annual cases in the United States and a significant number in Europe. Children under five years of age are particularly vulnerable to hospitalization. Methods: As timely assessment of exacerbation severity in the ED is critical, this review synthetizes data about tools such as the Pediatric Respiratory Assessment Measure (PRAM) and the Asthma Severity Score (ASS) aid in evaluating clinical status based on respiratory rate, oxygen saturation, accessory muscle use, and response to treatment. We also analyzed the proper management following established guidelines from GINA, NAEPP and other articles. Results: First-line therapy includes oxygen supplementation, short-acting beta-agonists (SABAs) administered frequently during the first hour, and early systemic corticosteroids. In moderate to severe cases, ipratropium bromide is added. For refractory or life-threatening presentations, intravenous magnesium sulfate, epinephrine, or ventilatory support may be required. Discharge is appropriate when symptoms resolve, oxygen saturation remains >94% on room air, and the child demonstrates adequate inhaler use. Hospitalization is indicated in cases of persistent hypoxemia, poor response, feeding difficulties, or social concerns. Post-discharge care includes thorough caregiver education, medication access, and a personalized asthma action plan to reduce recurrence risk. Conclusions: The effective diagnosis, appropriate exacerbation treatment, monitoring of patients in the post-attack period, as well as successful preventive medication play a key role in the management of pediatric patients with asthma. Full article

Background/Objectives: Pediatric asthma is a leading cause of emergency department visits, and air pollution is a known primary environmental trigger. Although worldwide air pollutants have been associated with asthma exacerbations, limited data have been reported in the Eastern Province of Saudi Arabia. This study aimed to investigate the relationship between air pollution and pediatric asthma admissions among children aged 2 to 14 years old at King Fahd Hospital of the University Hospital (KFHU). Methods: This is a retrospective cohort study, over 366 days, including 1750 pediatric asthma-related ER visits and daily concentrations of air pollutants (PM_2.5, PM₁₀, NO₂, SO₂, CO, and O₃) and meteorological factors (temperature and humidity). Various statistical models, such as Poisson regression and ARIMA, were applied to determine the association between pollutants levels and hospital ER visits. The data were visit-based in nature, and it was not possible to follow up with repeat visits or for admission status for individual patients. Results: Elevated levels of PM_2.5, NO₂, and CO were significantly associated with more pediatric asthma ER visits, mainly on the same day and with short lags. PM_2.5 displayed the strongest association, consistent with its deeper pulmonary penetration and greater toxicity. Also, PM₁₀ levels were inversely associated with ER visits, possibly due to particle size and deposition location differences. Significantly correlated with increased ER visits are lower ambient temperature and higher humidity. Conclusions: This study offers strong evidence on the relationship between air pollution and pediatric asthma events, in turn highlighting the vital importance of air quality regulation, public health policies, and clinical vigilance for environmental exposures. Full article

(1) Background: Children are the most vulnerable to pollution due to their decreased stature, heightened respiratory rate, and frequent outdoor engagement. PM_2.5, nitrogen dioxide (NO₂), ozone, and cold weather are associated with pediatric asthma. In this study, we investigated the nexus between air pollution, climate factors, and pediatric asthma emergency room visits (ERVs). (2) Method: Pediatric asthma ERV data for healthcare quality from the Taiwanese National Insurance in the Taipei area were obtained from 2015 to 2019. Air pollution and climate factor data were also collected. Poisson regression was employed to determine the relationships with relative risks (RRs). (3) Results: The incidence of pediatric asthma ERVs decreased, with a crude RR of 0.983 (95% CI: 0.98–0.986, p < 0.001). Fine particulate matter (PM_2.5) had an adjusted RR of 1.102 (95% CI: 1.037–1.172, p = 0.002) and a 7.7 µg/m³ increase, and air temperature had an adjusted RR of 0.813 (95% CI: 0.745–0.887, p < 0.001) comparing between the highest and lowest quarter air temperature associated with pediatric asthma ERVs. (4) Conclusions: This inquiry underscores the positive associations of PM_2.5 and cold weather with pediatric asthma ERVs. The findings could guide the government to establish policies to reduce air pollution and promote children’s health. Full article

(1) Background: An asthma exacerbation that is not relieved with medication typically requires an emergency room visit (ERV). The coronavirus disease 2019 (COVID-19) pandemic began in Taiwan in January of 2020. The influence of the COVID-19 pandemic on pediatric ERVs in Taiwan was limited. Our aim was to survey pediatric asthma ERVs in the COVID-19 era; (2) Methods: Data were collected from the health quality database of the Taiwanese National Health Insurance Administration from 2019 to 2021. Air pollution and climatic factors in Taipei were used to evaluate these relationships. Changes in the rates of pediatric asthma ERVs were assessed using logistic regression analysis. Poisson regression was used to evaluate the impact of air pollution and climate change; (3) Results: The rate of pediatric asthma ERVs declined in different areas and at different hospital levels including medical centers, regional and local hospitals. Some air pollutants (particulate matter ≤ 2.5 µm, particulate matter ≤ 10 µm, nitrogen dioxide, and carbon monoxide) reduced during the COVID-19 lockdown. Ozone increased the relative risk (RR) of pediatric asthma ERVs during the COVID-19 period by 1.094 (95% CI: 1.095–1.12) per 1 ppb increase; (4) Conclusions: The rate of pediatric asthma ERVs declined during the COVID-19 pandemic and ozone has harmful effects. Based on these results, the government could reduce the number of pediatric asthma ERVs through healthcare programs, thereby promoting children’s health. Full article

In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO₂; NO₂; O₃; CO; PM_2.5; PM₁₀) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered. Full article

In this research, we investigated the public health risks associated with atmospheric exposure to PM_2.5 for different subpopulations (black, white, Hispanic, youth, adults, and elderly) in the Washington, DC area. Washington, DC has long been considered a non-healthy place to live according to the American Lung Association due to its poor air quality. This recognition clearly includes the negative PM-related human health effects within the region. Specifically, DC fine particulate matter (PM_2.5) [or particulate matter with an aerodynamic diameter less than 2.5 μm] poses notable health risks to subpopulations having an annual mean value of 16.70 μg/m³ during the years 1999-2004, exceeding the EPA National Ambient Air Quality Standard (NAAQS) of 15 μg/m³. Incessant exposure to significant levels of PM has previously been linked to deleterious health effects, such as heart and lung diseases. The environmental quality and public health statistics of Washington, DC indicate the need for higher-resolution measurements of emissions, both spatially and temporally, and increased analysis of PM-related health effects. Our findings show that there are significant risks of ward-specific pediatric asthma emergency room visits (ERV). Results also illustrate lifetime excess lung cancer risks, exceeding the 1x10^-6 threshold for the measured levels of particulate matter and heavy metals (chromium and arsenic) on behalf of numerous subpopulations in the DC selected wards. Full article