Abstract
Indoor air pollution is increasingly recognized as a significant risk for respiratory illness, particularly in vulnerable populations. Thirty-six children aged 6–14 years with moderate/severe asthma from inner city areas in New York City were studied for 2-week periods (summer and winter) using diaries and spirometry. Seven-day integrated indoor samples of PM10, PM2.5, trace elements, elemental/organic carbon, black carbon, and criteria gases (NO2, SO2, and O3) were collected in the subjects’ residences. Asthma outcomes included cough and wheeze severity, albuterol use, and pulmonary function. Mixed effects regression models for longitudinal data were used to relate weekly indoor pollutant concentrations to asthma outcomes. Odds ratios (ORs) were calculated for ordinal outcomes. During winter, significant positive associations for average weekly symptom severity scores were seen for NO2 (OR = 2.83; p = 0.02), calcium (OR = 3.29; p = 0.02), and silicon (OR = 3.64; p = 0.04). In summer, chlorine was associated with average weekly symptom scores (OR = 1.85; p = 0.004). Average albuterol puff use per day in winter was associated with NO2 (OR = 5.89; p = 0.009), nickel (OR = 2.27; p = 0.05), and silicon (OR = 5.59; p = 0.05). Albuterol use was not associated with indoor pollutants in summer. Asthma severity was associated with specific indoor pollutants. Seasonal differences were observed by pollutant and by clinical index studied.
Highlights
In the USA, asthma is the most important chronic disease in children and young adults, affecting over 5 million in ages 5 to 17 years (Wang et al 2005)
We examine the associations of measured indoor pollutants and their seasonal variation on measures of asthma exacerbation in children with moderate to severe asthma living in inner city New York
NO2, Ca, and Si were significantly associated with average symptom score during winter, with Odds ratios (ORs) of 2.83, 3.29 (1.26–8.55), and 3.64 (1.10–12.05), respectively
Summary
In the USA, asthma is the most important chronic disease in children and young adults, affecting over 5 million in ages 5 to 17 years (Wang et al 2005). Notably fine particulate matter [PM2.5] and criteria gases (ozone [O3], nitrogen dioxide [NO2], and sulfur dioxide [SO2]), are well recognized as important contributors to exacerbations of asthma (Selgrade et al 2006; Gielen et al 1997; Iskandar et al 2012; Larsen et al 2002; Peters et al 1997; Roy et al 2011; Schachter et al 2016; Vedal et al 1998). While infiltration of outdoor air pollution does significantly contribute to the indoor environment, our previous analysis in these inner-city data indicate that ~ 72% of PM2.5 mass in these homes likely originated from indoor sources (Habre et al 2014b). Concentrations of indoor pollutants, like outdoor pollutants, are subject to seasonal variation and their effects may vary from one season to another (Bielroy and Deener, 1998)
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