Abstract

Background. Proximity to heavy traffic has been linked to increased asthma severity. However, it is unknown whether exposure to heavy traffic is associated with the ability to maintain asthma control. Objectives. This study examines whether exposure to heavy traffic is associated with the ability to maintain asthma control in inner-city children. Methods. 756 inner-city asthmatic Hispanic children were followed for one year in a pediatric asthma management program (Breathmobile). At each scheduled visit, asthma specialist tracked patients' asthma severity and managed their asthma based on the NAEPP guidelines. The patients' residential distance from the nearest freeway was calculated based on residential address at study entry. Distance to nearest freeway was used as a surrogate marker for high exposure from traffic-related air pollutants. Results. Patients who lived near a freeway were significantly more likely to have asthma that was not well controlled (P = .03). Patients with intermittent and mild baseline severity have a two-fold increased risk of having asthma that is uncontrolled if they lived <2 miles from a freeway (OR = 2.2, P = .04). Conclusion. In children with asthma, residential proximity to freeways is associated with uncontrolled asthma.

Highlights

  • Increasing evidence suggests that residential proximity to traffic sources increases the risk for the development of asthma [1] and asthma morbidity [2]

  • Factors contributing to patients having uncontrolled asthma include baseline severity (P < .01) and residential proximity to freeway (P = .03)

  • Results of this study provide strong evidence that residential proximity to freeway is associated with uncontrolled asthma

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Summary

Introduction

Increasing evidence suggests that residential proximity to traffic sources increases the risk for the development of asthma [1] and asthma morbidity [2]. Air pollution from heavy road traffic has been linked to increased asthma exacerbations, and asthma-related emergency department visits and hospitalizations [3, 4]. Particulate matter produces a strong inflammatory response in the airways involving various cells, mediators, cytokines, and adhesion molecules [8]. This is believed to contribute to worsening asthma severity. It is unknown whether exposure to heavy traffic is associated with the ability to maintain asthma control. This study examines whether exposure to heavy traffic is associated with the ability to maintain asthma control in inner-city children. Residential proximity to freeways is associated with uncontrolled asthma

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