Asthma Hospitalization Rates Among Children, and School Building Conditions, by New York State School Districts, 1991-2001

Abstract

School-age children spend a significant portion of their day at school where they can be exposed to asthma triggers, but little information exists regarding potential relationships between childhood asthma and school environmental factors. This study examined patterns of asthma hospitalization and possible factors contributing to asthma hospitalizations, including sociodemographics and school environmental factors, among school-age children (5-18 years) in New York State (NYS) over an 11-year period (1991-2001). Asthma hospitalization data from the Statewide Planning and Research Cooperative System and the 1990 and 2000 census population files were geocoded into NYS school districts statewide, and school district asthma hospitalization rates were then calculated. Building Condition Survey for each school was then utilized to create summary measures of school building conditions for each school district. Hospitalization rates were linked to district school building conditions by using logistic regression analysis that controlled for poverty. Calculation of time trends revealed overall declines in asthma rates among school-age children for NYS from 1991 to 2001. This general decline was found in each sociodemographic group. The mean rate for NYS from 1991 to 2001 was 27/10,000. Poorly rated building systems that were significantly associated with increased school district asthma hospitalization rates were roofing (odds ratio [OR] = 1.76; 95% confidence interval [CI(95)] = 1.13-2.74), windows (OR = 1.66; CI(95)= 1.08-2.54), exterior walls (OR = 2.24; CI(95)= 1.31-3.83), floor finishes (OR = 1.75; CI(95)= 1.14-2.69), and boiler/furnace (OR = 1.71; CI(95)= 1.99-2.94). This does not indicate a definite link between these systems and asthma hospitalizations since the available building system information is very general and crude.