715: CLIMATE AND WEATHER AS RISK FACTORS FOR PEDIATRIC ASTHMA EXACERBATIONS: A SCOPING REVIEW

Abstract

Introduction: Climate change is leading to more weather events and swings in outdoor temperature. The relationship between asthma and such events is understudied, especially accounting for pollution, pollen, and viral illnesses. With higher respiratory rates, children are uniquely vulnerable to climate change, therefore this literature gap needs to be urgently addressed to identify interventions. The aims of this scoping review are (1) identify previously described relationships of weather/climate with asthma, (2) summarize the evidence on timing of exposure to exacerbation and (3) map the current body of international literature. Methods: Using the Joanna Briggs Institute’s Preferred Reporting Items for Scoping Review, a review of the full-text literature was conducted. PubMed, Scopus, Web of Science and EMBASE were used to search the concepts of (1) asthma, (2) weather or climate, and (3) emergency department or hospitalization for studies before February 2022. Results: Of the 12,692 studies identified, a total of 66 relevant studies were selected based on criteria of age < 18 years. Of the 66 studies, 88% looked at daily temperature via daily mean, max, min or diurnal temperature range. Of the 66 studies, 71% accounted for pollution, 14% for pollen, 9% for viral illnesses, and 8% for weather events such as thunderstorms. Most studies reported positive associations between high diurnal temperature range and asthma-related admissions or ED visits. Most studies reported the lower the daily minimum temperature the more likely an asthma exacerbation to occur. Results were mixed for high daily maximum temperature and asthma exacerbations. Few studies attempted to ascertain the timing between exposure and exacerbation, although most studies only considered asthma exacerbations within 2 weeks of an exposure. Finally, most studies used airport temperature sensors to assume the patient’s exposure and none geocoded patient data to assess more local exposure. Conclusions: Future studies are needed to understand the timing of asthma exacerbations from known climate change-related weather events such as large diurnal temperature range and thunderstorms– especially how they vary by neighborhood. Future studies need to identify key times to intervene in pediatric asthma when trigger events can be predicted.