Ambient air pollutants and pulmonary function in children after COVID-19 pandemic

Abstract

BACKGROUND AND AIM: The acute effects of air pollutants on pulmonary function remain unclear. After COVID-19 spreads, fear drives patients away from hospitals. Smartphone applications may help asthma care. This study investigated the acute effects of ambient air pollution on pulmonary function among asthma in children by smartphone applications. METHODS: We designed a smartphone app to provide timely support for patients with asthma. Peak expiratory flow (PEF) recordings were made twice daily and was corrected by age and gender. The severity of asthma by GINA guideline and asthma control test (ACT) test score were also monitored. Ambient air pollution parameters of particulate matter (PM), ozone(O3), oxides of nitrogen (NO2),carbon monoxide (CO), and sulfur dioxide (SO2) were measured from each nearby air monitoring station at each time while PEF recordings by linking to Global Positioning System. Allergen-specific IgE were also measured by MAST. Effects of exposure to pollutants on PEF were assessed in person-days of observations by GEE model. RESULTS: In lag 0 (the same day), PM10, NO2, CO, and SO2 were negatively correlated with PEF (p=0.030, 0.031, 0.008, 0.017). In lag1 (one day before), NO2, CO, and SO2 were found to be correlated PEF (p=0.005, 0.010, 0.025). In lag2, PM2.5, PM10, NO2, and SO2 were associated with PEF (p=0.031, 0.023, 0.031, 0.005). Analyses stratified by mite allergen sensitization revealed that PM10, NO2, CO, and SO2 air pollutant levels negatively correlated with PEF only in mite sensitization children. CONCLUSIONS: Exposure to air pollutants can lead to acute effects on the pulmonary function in children with asthma. Pollutants may reduce lung function and have different effects over time. Mite sensitization might modify the effect of air pollutant exposures on lung function on asthma. Smartphone applications are readily available tools to help individual air monitoring and asthma care after COVID-19 pandemic.