Cases Of Childhood Asthma Research Articles

C-CBL/LCK/c-JUN/ETS1/CD28 axis restrains childhood asthma by suppressing Th2 differentiation

BackgroundAsthma is a common immune disease with high morbidity in children. Type 2 inflammation is the center of asthma development, and mainly mediated by a subset of CD4 + T cells, T helper 2 (Th2) cells. Excess Th2 differentiation was generally associated with asthmatic attack. Casitas B-lineage lymphoma (c-CBL) was reported to involved in T cell development and databank showed its decreased expression in CD4 + T cells from peripheral blood of asthmatic children. This study aims to investigate the role of c-CBL in childhood asthma and Th2 differentiation, and explore the underlying mechanism.MethodsWe collected peripheral blood samples from clinical childhood asthma cases and healthy controls, and determined c-CBL expression in CD4 + T cells. Asthma was induced in neonatal mice by ovalbumin (OVA) intraperitoneal injection and aerosol inhalation, and c-CBL expression in CD4 + T cells from peripheral blood and spleen was measured. Gain-of-function experiments was performed to confirm the effects of c-CBL on Th2 differentiation in vitro. Finally, c-CBL was delivered into asthmatic mice via lentivirus infection to verify its effects on experimental asthma.Resultsc-CBL was lowly expressed in CD4 + T cells from asthmatic children than those of healthy controls. Similarly, it was downregulated in CD4 + T cells from peripheral blood and spleen of asthma mice. Overexpression of c-CBL restrained lung pathological injury and type 2 inflammation in experimental asthmatic mice. Gain-of-function experiments demonstrated that c-CBL inhibited Th2 differentiation of CD4 + T cells from healthy children, and mediated the ubiquitination of lymphocyte cell-specific protein-tyrosine kinase (LCK). LCK acted as a kinase to phosphorylate and activate c-JUN, which was predicted to bind promoter sequence of CD28 by bioinformatic analysis. Dual-luciferase reporter assay verified that c-JUN and ETS1 synergically enhanced transcription of CD28, and this transcription activation was aggravated by LCK overexpression.Conclusionc-CBL alleviated asthma and suppressed Th2 differentiation by facilitating LCK ubiquitination, interrupting c-JUN activation and CD28 expression in vivo and in vitro. c-CBL/LCK/c-JUN/ETS1/CD28 axis was partially involved in childhood asthma, and may provide novel insights for clinical treatment for asthma.

Adopting electric school buses in the United States: Health and climate benefits

Electric school buses have been proposed as an alternative to reduce the health and climate impacts of the current U.S. school bus fleet, of which a substantial share are highly polluting old diesel vehicles. However, the climate and health benefits of electric school buses are not well known. As they are substantially more costly than diesel buses, assessing their benefits is needed to inform policy decisions. We assess the health benefits of electric school buses in the United States from reduced adult mortality and childhood asthma onset risks due to exposure to ambient fine particulate matter (PM2.5). We also evaluate climate benefits from reduced greenhouse-gas emissions. We find that replacing the average diesel bus in the U.S. fleet in 2017 with an electric bus yields $84,200 in total benefits. Climate benefits amount to $40,400/bus, whereas health benefits amount to $43,800/bus due to 4.42*10-3 fewer PM2.5-attributable deaths ($40,000 of total) and 7.42*10-3 fewer PM2.5-attributable new childhood asthma cases ($3,700 of total). However, health benefits of electric buses vary substantially by driving location and model year (MY) of the diesel buses they replace. Replacing old, MY 2005 diesel buses in large cities yields $207,200/bus in health benefits and is likely cost-beneficial, although other policies that accelerate fleet turnover in these areas deserve consideration. Electric school buses driven in rural areas achieve small health benefits from reduced exposure to ambient PM2.5. Further research assessing benefits of reduced exposure to in-cabin air pollution among children riding buses would be valuable to inform policy decisions.

Evaluation of IL-4 and IL-13 Single Nucleotide Polymorphisms and Their Association With Childhood Asthma and Its Severity: A Hospital-Based Case-Control Study.

Asthma is a common, chronic, atopic respiratory disease that is on the rise among children and adults worldwide. Various environmental, genetic, and biological interactions contribute to the surge in susceptibility to this disease. Interleukin (IL) genes, particularly IL-4 and IL-13, have been linked to asthma pathogenesis. The present study aims to investigate the genetic aberrations, specifically single nucleotide polymorphisms (SNPs) of IL-4 and IL-13, and their association with childhood asthma and its severity. An unmatched hospital-based case-control study was conducted in a tertiary care hospital in Assam, India. The sample size was calculated to be 120 (60 cases and 60 controls) using the Epi Info software version 7.2 (Centers for Disease Control and Prevention, Atlanta, GA, USA), assuming a confidence interval of 95%, a power of the study at 80%, a ratio of control to cases as 1, a proportion of controls with exposure at 22%, and a proportion of cases with exposure at 46%. A total of 53 clinically diagnosed cases of childhood asthma in the age range of three to 12 years and 39 healthy controls free from respiratory diseases and having no history of asthma and/or allergy of the same age group attending a tertiary care hospital were included in the study. Children who never had asthma or allergies and who did not suffer from any upper or lower respiratory infections for the previous four weeks were considered controls. Prior informed consent and ethical clearance were obtained. Very seriously ill cases and controls were excluded from the study. The genetic investigation used polymerase chain reaction (PCR), followed by restriction fragment length polymorphism (RFLP), to discover SNPs in the IL-4 and IL-13 genes. Sequencing analysis was done for the cases with +2044 G>A of the IL-13 gene in relation to the severity of the disease. The difference in the proportions of specific SNPs between cases and controls was analyzed using the χ2test (a p-value of <0.05 was considered significant). Both the rs2070874 and rs2243250 polymorphisms of IL-4 showed no statistically significant associations. The mutation of the IL-13 gene in 1111C>T was higher among cases than controls. Both genotypic and allelic distributions of the +2044G>A polymorphism of the IL-13 gene revealed a significant association (p<0.05) with the severity of the disease. Genetic aberrations in SNPs of IL-4 and IL-13 are prevalent among the pediatric patients of the study region. The SNP +2044G>A of IL-13 is instrumental in disease manifestation and severity among the pediatric population of the study region.

Changes in industrial air pollution and the onset of childhood asthma in Quebec, Canada

Ambient air pollution has been associated with asthma onset and exacerbation in children. Whether improvement in air quality due to reduced industrial emissions has resulted in improved health outcomes such as asthma in some localities has usually been assessed indirectly with studies on between-subject comparisons of air pollution from all sources and health outcomes. In this study we directly assessed, within small areas in the province of Quebec (Canada), the influence of changes in local industrial fine particulate matter (PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2) concentrations, on changes in annual asthma onset rates in children (≤12 years old) with a longitudinal ecological design. We identified the yearly number of new cases of childhood asthma in 1282 small areas (census tracts or local community service centers) for the years 2002, 2004, 2005, 2006, and 2015. Annual average concentrations of industrial air pollutants for each of the geographic areas, and three sectors (i.e., pulp and paper mills, petroleum refineries, and metal smelters) were estimated by the Polair3D chemical transport model. Fixed-effects negative binomial models adjusted for household income were used to assess associations; additional adjustments for environmental tobacco smoke, background pollutant concentrations, vegetation coverage, and sociodemographic characteristics were conducted in sensitivity analyses. The incidence rate ratios (IRR) for childhood asthma onset for the interquartile increase in total industrial PM2.5, NO2, and SO2 were 1.016 (95% confidence interval, CI: 1.006–1.026), 1.063 (1.045–1.090), and 1.048 (1.031–1.080), respectively. Positive associations were also found with pollutant concentrations from most individual sectors. Results suggest that changes in industrial pollutant concentrations influence childhood asthma onset rates in small localities.

Construction and Intervention Effectiveness Analysis of a Combined Cough and Asthma Pharmacy Outpatient Service Model for Children's Asthma

To explore the service model and application effectiveness of cough and asthma pharmacy combined outpatient service for chronic respiratory diseases, researchers collected 107 cases of childhood asthma from July 2021 to December 2022, and divided them into two groups based on their age, receiving routine pharmaceutical services and personalized pharmaceutical services. Children under 5 years old received TRACK scores, while children over 5 years old received C-ACT scores to evaluate their asthma control, and statistical analysis was conducted. After providing pharmaceutical services, the TRACK score and C-ACT score of the experimental group were significantly higher than those of the control group, and the differences were statistically significant. The joint medical clinic established by clinical pharmacist cough and asthma pharmacy and pediatric asthma standardization clinic can significantly improve the treatment effect of pediatric asthma, and reduce recurrence rate and treatment costs.

The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing

Quantifying the burden of disease from exposure to poor indoor air pollution can support policy development. In England, there is current regulatory and public attention on the health implications of residential exposure to formaldehyde, damp and mould. However, there is scarce information on these health impacts at the population scale. As such, we assessed the burden of key respiratory diseases from residential formaldehyde, damp and/or mould for the English population aged 0–14 and 15–49. We obtained data on the percentage of dwellings affected by damp and/or mould from the English Housing Survey and estimated the distribution of residential formaldehyde concentrations (annual average (μg/m3)) by pooling data from monitoring studies conducted in England. Exposures were combined with epidemiological relationships and national health data to estimate Population Attributable Fractions (PAFs), disease incidence, and Disability Adjusted Life Years (DALYs) lost associated with residential formaldehyde or damp and/or mould exposure in England. We made estimates for the year 2019 but also looked back several years in time. Exposure to formaldehyde was associated with approximately 4000 new cases of childhood asthma (~800 DALYs lost) in 2019, though the estimates were sensitive to the placement of the lower exposure threshold. Exposure to damp and/or mould was associated with approximately 5000 new cases of asthma (~2200 DALYs) and approximately 8500 lower respiratory infections (~600 DALYs) among children and adults in 2019, though the PAFs were unequally distributed across dwellings based on income and ethnicity. Alternative data sources suggest that the percentage of dwellings affected by damp and/or mould may even be higher, resulting in a possible 3–8-fold greater number of cases and DALYs. Our assessment emphasizes a potential respiratory health burden in England associated with residential formaldehyde as well as damp and/or mould, further highlighting the public health importance of good indoor air quality and good quality housing.

Determinants of Childhood Asthma: A Case Control Study from a Tertiary Care Hospital in Bengaluru, South India.

Childhood asthma is a common, and often serious, chronic disease with episodic exacerbations in infants and children. There is an increasing trend in the prevalence of childhood asthma in developing countries. Objectives: To identify the determinants of childhood asthma. A case control study with 30 cases of childhood asthma and 30 gender- and aged-matched controls selected from the paediatric outpatient department and paediatric ward of a tertiary hospital. The primary caregiver was interviewed to capture sociodemographic details, prenatal and birth history, and history of exposure to environmental risk factors. Odds ratios with 95% confidence intervals were calculated to determine the strength of association between childhood asthma and independent co-variates, followed by subgroup multiple logistic regression analysis. We found that children with a parental history of allergy/atopy [OR=2.88 (1.94-4.27), P<0.001], residence in houses located in industrial areas [AOR=2.72 (2.6-323.1), P<0.001], exposure to incense at home [AOR=2.03 (1.14-29.42), P<0.001], or a history of allergic rhinitis [AOR=3.09 (2.22-243.25), P<0.001] had significantly higher odds of developing childhood asthma. Our study found that having homes located in industrial areas, burning incense at home, parental history of allergy, and history of allergic rhinitis in the child are determinants of childhood asthma. The findings from our study can be used to generate awareness regarding risk factors that are linked to childhood asthma.

Air pollution and health impacts of oil & gas production in the United States

Oil and gas production is one of the largest emitters of methane, a potent greenhouse gas and a significant contributor of air pollution emissions. While research on methane emissions from oil and gas production has grown rapidly, there is comparatively limited information on the distribution of impacts of this sector on air quality and associated health impacts. Understanding the contribution of air quality and health impacts of oil and gas can be useful for designing mitigation strategies. Here we assess air quality and human health impacts associated with ozone, fine particulate matter, and nitrogen dioxide from the oil and gas sector in the US in 2016, and compare this impact with that of the associated methane emissions. We find that air pollution in 2016 from the oil and gas sector in the US resulted in 410 000 asthma exacerbations, 2200 new cases of childhood asthma and 7500 excess deaths, with $77 billion in total health impacts. NO2 was the highest contributor to health impacts (37%) followed by ozone (35%), and then PM2.5 (28%). When monetized, these air quality health impacts of oil and gas production exceeded estimated climate impact costs from methane leakage by a factor of 3. These impacts add to the total life cycle impacts of oil and gas, and represent potential additional health benefits of strategies that reduce consumption of oil and gas. Policies to reduce oil and gas production emissions will lead to additional and significant health benefits from co-pollutant reductions that are not currently quantified or monetized.

A comparative study of bacteriological profile and outcomes in infective exacerbation of chronic obstructive pulmonary disease and bronchial asthma

Background: According to the Global Burden of Disease 2018, chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and in India, COPD is the second leading cause of death among noncommunicable diseases. Among India’s 1.31 billion people, about 6% of children and 2% of adults have bronchial asthma. Infective exacerbations of both COPD and Bronchial asthma are common. However, there are some differences in the bacterial spectra between the two conditions, and profiling the bacteria responsible for the exacerbations will help in choosing appropriate antibiotics and also to combat the issue of drug resistance. Aims: (1) To analyze the bacteriological profile of patients with infective exacerbation of COPD and bronchial asthma. (2) To study the outcomes among these patients. Subjects and Methods: The study was a prospective observational study conducted from November 2019 to May 2020 in Bangalore Medical College and Research Institute on 50 patients diagnosed with acute exacerbation of COPD and 50 patients diagnosed with an exacerbation of bronchial asthma. Detailed history, physical examination, and standard laboratory tests were done on admission. Sputum samples were collected from the patients and analyzed by Gram staining and microscopy and also by culture. The differences between the two groups were analyzed. The progression of the disease and the outcomes were observed. Results: 100 patients were included in our study, 50 each in COPD and bronchial asthma. The study was conducted in hospitals attached to BMCRI. Bacteriological profile was assessed by sputum culture and antibiotic sensitivity in the COPD and asthma groups, respectively. In our study, in the COPD group, majority (80%) of patients were males, the mean age was 64.34 ± 9.876, and 80% were smokers with 20% having exposure to biomass. The most common growth in COPD exacerbation was Streptococcus pneumoniae (18%) followed by Haemophilus influenzae and Klebsiella pneumoniae. Mortality in COPD exacerbation was 12%. In the asthma group, female preponderance was seen (54%), mean age was 40.64 ± 13.11. Majority of patients were cases of childhood asthma. Growth was seen in 32% of exacerbations and the most common organism was Streptococcus pneumoniae. Mortality was 4% and importantly due to comorbidities. Conclusions: Bacterial exacerbations are more common in COPD, while it is not so in bronchial asthma. Viral exacerbations and atypical bacterial exacerbations are more common and asthma associated with pneumonia is the cause for culture growth. Mortality is considerably low in the asthma group compared to COPD exacerbations.

Estimating ambient air pollution mortality and disease burden and its economic cost in Barcelona

BackgroundThe new WHO air quality guidelines indicate that the air pollution disease burden is greater than previously reported. We aimed to estimate the air pollution disease burden and its economic cost in Barcelona to inform local action. MethodsWe used a quantitative health impact assessment to estimate the non-accidental mortality and incidence of childhood asthma and lung cancer attributable to long-term air pollution exposure in the city of Barcelona (Spain) in 2018–2019. We used the population weighted mean of PM2.5 and NO2 assigned at the geocoded address during the study period and the 2021 WHO air quality guidelines as counterfactual scenario to estimate new annual cases attributable to each pollutant separately and combined. We estimated the social cost of attributable deaths and the health care cost of childhood asthma and lung cancer attributable cases. We also estimated attributable mortality by city district and the mortality avoidable by achieving the WHO air quality interim targets. ResultsMean exposure was 17 μg/m3 for PM2.5 and 39 μg/m3 for NO2. Total combined air pollution attributable mortality was 13% (95%CI = 9%–17%), corresponding to 1,886 deaths (95%CI = 1,296–2,571) and a social cost of €1,292 million (95%CI = 888–1,762) annually. Fifty-one percent (95%CI = 21%–71%) and 17% (95%CI = 7%–29%) of new cases of childhood asthma and lung cancer were attributable to air pollution with a health care cost of €4.3 and €2.7 million, respectively. Achieving the first unmet WHO air quality interim targets for PM2.5 and for NO2 would avoid 410 deaths and €281 million annually. ConclusionAir pollution in Barcelona represents a huge disease and economic burden, which is greater than previous estimates. Much stronger measures to reduce PM2.5 and NO2 levels are urgently needed. Until the WHO air quality guidelines are met in the city, achieving each WHO air quality interim targets would avoid hundreds of deaths each year.

Community Interventions for Childhood Asthma ED Visits and Hospitalizations: A Systematic Review.

Structural and social determinants of childhood asthma inequities manifest within geographic communities that are often segregated. Childhood asthma disproportionately affects Black, Hispanic, and low-income populations. Community interventions have the potential to improve inequities in emergency healthcare. This systematic review was conducted to assess the effectiveness of childhood asthma community interventions and provide a conceptual model to inform implementation of future community interventions. Publications from PubMed, ScienceDirect, CINAHL, Cochrane Library, Web of Science, and hand searched references were examined from 2010 to 2021. Community intervention studies among children with asthma were included. Main outcomes were emergency department visits and hospitalizations. Community interventions exclusively focusing on schools or hospitals were excluded. Two reviewers independently assessed eligibility for final inclusion. Emergency healthcare findings were extracted in addition to co-benefits (eg, fewer missed school days and caregiver workdays). Out of 1856 records, 26 publications met the inclusion criteria. Community interventions were categorized by care coordination (n = 8), policy and environmental changes (eg, smoke-free legislature, traffic reduction models, and green housing) (n = 8), home-based (n = 6), and community-based health services (n = 4). Selected studies indicated that community interventions significantly reduced childhood asthma emergency department visits and hospitalizations through increased caregiver self-efficacy, home environmental trigger reduction, and increased access to healthcare. Because of heterogeneity among studies, we were unable to conduct a meta-analysis. Findings show significant associations between community interventions and the reduction of emergency healthcare, suggesting a protective effect for severe cases of childhood asthma.

Spatiotemporal Analysis of PM2.5 Concentrations on the Incidence of Childhood Asthma in Developing Countries: Case Study of Cartagena de Indias, Colombia

The increase in airborne pollution in large cities since the mid-20th century has had a physiologically proven impact on respiratory health, resulting in the irritation and corrosion of the alveolar wall. One of the demographics of the population most affected by this problem is children. This study focuses on the relationship between particulate matter of 2.5 µm (PM2.5) and childhood asthma, which is one of the main respiratory diseases identified in developing countries. The city of Cartagena de Indias, Colombia, is taken as a case study. A relevant correlation between childhood asthma and PM2.5 is found. Incidence series of paediatric asthma on a monthly scale and PM2.5 records in the city of Cartagena are considered. As is common in developing countries, the series was incomplete due to a lack of experts and insufficient economical resources. Therefore, several statistical and analytical processes were applied to provide sufficient quality to the series. An improvement of the time scale of the records was carried out, as well as the completion (statistical imputation) of missing data due to low statistical significance, by applying Rstudio®, PAST® and SPSS®. The last phases consisted of the determination of the main factors that cause childhood asthma incidence, the estimation of the correlation between asthma incidence and PM2.5, as well as the estimation of health impact. A reduction in PM2.5 concentration was simulated using BenMap-CE software to reach safe levels according to the WHO guidelines on air quality to identify preventable cases of childhood asthma, as air pollution has been found to be related to this disease. In addition, a log-linear model was applied to determine the number of hospital visits avoided after reducing the levels of PM2.5 concentration to the maximum levels recommended by WHO. The results showed a good agreement between childhood asthma incidence and PM2.5 pollutants in the spectral analysis (75% coincidence) and Chi2 (85.5% of coincidence) assessments, while visual correlation, mean and linear regression showed lower relations (61.0%, 55.5% and 0.48%, respectively). A reduction to a safe level of 5 µg/m3 would lead to a reduction of 240 annual cases of childhood asthma (95% CI: 137–330).

Estimated public health benefits of a low-emission zone in Malmö, Sweden

Air pollution is one of the leading causes of morbidity and mortality worldwide. Low-emission zones (LEZ) have been increasingly implemented in cities throughout Europe as a measure to reduce the adverse health effects and premature deaths associated with traffic-related air pollution. In the present study, a health impact analysis was conducted to estimate the effect of a hypothetical LEZ on mortality and morbidity in Malmö, Sweden. Baseline health statistics were gathered from health registers and applied to each resident according to individual-level data on age and/or sex. Concentration-response parameters were derived from current epidemiological literature, specifically meta-analyses. A Gaussian dispersion model (AERMOD) combined with a detailed emission database was used to calculate NO2 emissions from traffic, which could be applied on an individual-level using data on each person's residential coordinates. The adjusted exposure scenario replaced all vehicles on municipal roads having Euro 5 or lower emission standards with Euro 6 equivalents. This LEZ would, on average, decrease NO2 concentrations by 13.4%, preventing an estimated 9–26 deaths in Malmö each year. Additionally, 12 respiratory disease hospitalizations, 8 childhood asthma cases, and 9 cases of hypertensive disorders of pregnancy were estimated to be avoided annually. These results suggest that LEZs can effectively improve air quality, reduce greenhouse gas emissions, and safeguard public health.

An observational retrospective study on the prevalence of childhood asthma in rural areas of Kanyakumari

Asthma is a significant non-communicable illness imposing a substantial burden on the health system globally. Approximately 300 million people worldwide have asthma, and it's anticipated that another 100 million will have it by 2025. Being the most prevalent chronic illness in children, asthma is a major reason for missed school days, sleep disturbances, and activity limitations. It is a significant health problem in developing countries like India. Information on the prevalence of childhood asthma in India's rural areas is still lacking. Hence, the objective of this retrospective study is to observe the trends in the prevalence of childhood Bronchial Asthma in Kanyakumari District, Tamilnadu and to find out the most commonly indicated homoeopathic remedy for childhood asthma. A retrospective observational study was done on 44 cases of childhood asthma taken between January and December 2021 from the Out-Patient Department of Sarada Krishna Homoeopathic Medical College. This study concluded that children above 10 years are more prone to develop Bronchial Asthma and the most commonly indicated medicine is Arsenicum album, and the most frequently used potency is 0/6.

Modeling future asthma attributable to fine particulate matter (PM2.5) in a changing climate: a health impact assessment.

Exposure to fine particulate matter (PM2.5) is associated with asthma development as well as asthma exacerbation in children. PM2.5 can be directly emitted or can form in the atmosphere from pollutant precursors. PM2.5 emitted and formed in the atmosphere is influenced by meteorology; future changes in climate may alter the concentration and distribution of PM2.5. Our aim is to estimate the future burden of climate change and PM2.5 on new and exacerbated cases of childhood asthma. Projected concentrations of PM2.5 are based on the Geophysical Fluid Dynamics Laboratory Coupled Model version 3 climate model, the Representative Concentration Pathway 8.5 greenhouse gas scenario, and two air pollution emissions datasets: a 2011 emissions dataset and a 2040 emissions dataset that reflects substantial reductions in emissions of PM2.5 as compared to the 2011 inventory. We estimate additional PM2.5-attributable asthma as well as PM2.5-attributable albuterol inhaler use for four future years (2030, 2050, 2075, and 2095) relative to the year 2000. Exacerbations, regardless of the trigger, are counted as attributable to PM2.5 if the incident disease is attributable to PM2.5. We project 38 thousand (95% CI 36, 39 thousand) additional PM2.5-attributable incident childhood asthma cases and 29 million (95% CI 27, 31 million) additional PM2.5-attributable albuterol inhaler uses per year in 2030, increasing to 200 thousand (95% CI 190, 210 thousand) additional incident cases and 160 million (95% CI 150, 160 million) inhaler uses per year by 2095 relative to 2000 under the 2011 emissions dataset. These additional PM2.5-attributable incident asthma cases and albuterol inhaler use would cost billions of additional U.S. dollars per year by the late century. These outcomes could be mitigated by reducing air pollution emissions.

Opportunity to reduce paediatric asthma in New South Wales through nitrogen dioxide control

ObjectiveThe main sources of nitrogen dioxide (NO2), road vehicles and electricity generation, are currently in a period of technological change. We assessed the number of cases of childhood asthma in New South Wales that could be avoided by lowering exposure to NO2 by 25% from current levels. MethodsHealth impact assessment calculations for each of the 128 local government areas were based on the population of children aged 2 to 14, the prevalence of asthma derived from the 2017 NSW health survey, NO2 exposure from a land‐use regression model using satellite data, and risk estimates derived from two meta‐analyses and one Australian study. ResultsA 25% reduction in NO2 below current exposure would lead to between 2,597 and 12,286 fewer children with asthma in NSW. The wide range in these estimates reflects the variation in concentration‐response functions used. ConclusionsEven the lowest of these estimates would be a worthwhile reduction in this common childhood illness. Implications for public healthA 25% reduction in NO2 is ambitious, but it is achievable through improved vehicle exhaust standards, increasing electric vehicle numbers, and reform of the electricity sector. Current Australian ambient air quality standards for annual NO2 should be revised downwards.

Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010.

Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. Objective: The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. Methods: We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. Results: The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20–$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62–$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06–$144,269.18). Conclusion: This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP’s impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population’s exposure.

Large-scale citizen science provides high-resolution nitrogen dioxide values and health impact while enhancing community knowledge and collective action

We present outcomes from a large-scale air quality citizen science campaign (xAire, 725 measurements) to demonstrate its positive contribution in the interplay between advances in exposure assessment and developments in policy or collective action. A broad partnership with 1,650 people from communities around 18 primary schools across Barcelona provided the capacity to obtain unprecedented high-resolution NO2 levels and an updated asthma Health Impact Assessment. It is shown that NO2 levels vary considerably with at some cases very high levels. More than a 1,000 new cases of childhood asthma could be prevented each year by lowering NO2 levels. Representativity of site selection and the minimal number of samplers for land use regression modelling are considered. Enhancement of community knowledge and attitudes towards collective response were observed and identified as key drivers for successful large-scale monitoring campaigns. The results encourage strengthening collaboration with local communities when exploring environmental health issues.

Dysregulation of Circulating Monocytes is Associated with Exposure to Air Pollution and Asthma in Children

Although it is recognized that exposure to ambient air pollution containing particulate matter with a diameter of less than 2.5 micrometers (PM2.5) is responsible for more than a million cases of childhood asthma per year, the underlying mechanisms remain to be precisely addressed. It has not been demonstrated whether increased levels of exposure to PM2.5 is associated with dysregulation of monocytes in healthy and asthmatic children, or if pollution primes monocytes to develop a hyperinflammatory response termed “trained immunity”.

House Dust Mite Allergen Levels of Der p1 and Der f1 in Houses of Asthmatic Children

Background: Exposure to house dust mites is an important cause of asthma among children. The main asthma-causing mites found in homes are Dermatophagoides farinae and Dermatophagoides. pteronyssinus. Der f1 or Der p1 are allergens of the mentioned mites. This study aimed to assess the levels of Der p1, and Der f1 in the homes of families that had a case of childhood asthma in a northern city of Iran and to determine the association between indoor house environment and the level of mites allergens present there. Objectives: This study aimed to evaluate House Dust Mite Allergen Levels of Der p1 and Der f1 in Houses of Asthmatic Children. Methods: Dust samples were collected from bedrooms of 91 homes of families that had cases of childhood asthma. Families filled a questionnaire about demographical characteristics and the indoor condition of their living environment. The levels of Der f1 and Der p1 were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed in SPSS v. 24 and a P-value less than 0.05 was considered significant. Results: we found that Der p1 was more prevalent than Der f1 among samples. The mean concentration of Der p1 concentration was 271.35 ng/g (9 times greater than the concentration of Der f1). When the indoor environment status was evaluated, it was found that keeping pets and having old carpets are associated with Der f1 (P&lt;0.05). However, no significant association was found between Der p1 and the indoor conditions of the home. Conclusions: Our study showed that Der p1 level is higher than Der f1 level in the houses of children with asthma. We suggest removing carpets and pets from the house.