Joshua R Pepper1, Meredith A Barrett2, Jason G Su3, Rajan Merchant4, Kelly Henderson2, David Van Sickle5, John R Balmes6. 1. University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, United States. 2. Propeller Health, Research, San Francisco, CA, United States. 3. School of Public Health, University of California, Berkeley, CA, United States. 4. Dignity Health, Woodland Clinic Medical Group, Woodland, CA, United States. 5. Propeller Health, Madison, WI, United States; Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States. 6. University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, United States; School of Public Health, University of California, Berkeley, CA, United States; Department of Medicine, School of Medicine, University of California, San Francisco, CA, United States. Electronic address: john.balmes@ucsf.edu.
Abstract
RATIONALE: Asthma is one of the most common chronic respiratory diseases in the United States. Several outdoor air pollutants have been associated with asthma morbidity. Previous studies of the effects of short-term air pollution exposure have been limited by potential exposure misclassification and limited spatial and temporal resolution of asthma outcome measures. OBJECTIVES: We aimed to assess the association of short-term air pollutant exposure with the use of short-acting beta-2 agonists (SABA) for asthma by monitoring the time and place of occurrence with electronic medication monitors. METHODS: In a cohort of adults and children with asthma (n = 287; 60% female), we deployed electronic medication monitors fitted to metered-dose inhalers to monitor SABA use, capturing the date, time and location of use. We assigned pollutant exposures based on each actuation's time and location (4-h mean measures for ozone and particulate matter of 2.5 µm or smaller (PM2.5)), assessed associations using generalized linear models and explored age-specific effects. MEASUREMENTS AND MAIN RESULTS: Ambient ozone exposure was positively associated with SABA use (p = 0.01). Age-specific associations were identified (interaction p = 0.01), with a larger increase in SABA use for children (11.3%; 95% CI: 7.0%-18.2%) than adults (8.4%; 95% CI: 6.4%-11.0%) per IQR increase of ozone (16.8 ppb). CONCLUSIONS: These findings support existing evidence that short-term exposure to ozone can cause morbidity in individuals with asthma, and suggest that ozone exposures below the current U.S. EPA standard may be associated with increased SABA use.
RATIONALE: Asthma is one of the most common chronic respiratory diseases in the United States. Several outdoor air pollutants have been associated with asthma morbidity. Previous studies of the effects of short-term air pollution exposure have been limited by potential exposure misclassification and limited spatial and temporal resolution of asthma outcome measures. OBJECTIVES: We aimed to assess the association of short-term air pollutant exposure with the use of short-acting beta-2 agonists (SABA) for asthma by monitoring the time and place of occurrence with electronic medication monitors. METHODS: In a cohort of adults and children with asthma (n = 287; 60% female), we deployed electronic medication monitors fitted to metered-dose inhalers to monitor SABA use, capturing the date, time and location of use. We assigned pollutant exposures based on each actuation's time and location (4-h mean measures for ozone and particulate matter of 2.5 µm or smaller (PM2.5)), assessed associations using generalized linear models and explored age-specific effects. MEASUREMENTS AND MAIN RESULTS: Ambient ozone exposure was positively associated with SABA use (p = 0.01). Age-specific associations were identified (interaction p = 0.01), with a larger increase in SABA use for children (11.3%; 95% CI: 7.0%-18.2%) than adults (8.4%; 95% CI: 6.4%-11.0%) per IQR increase of ozone (16.8 ppb). CONCLUSIONS: These findings support existing evidence that short-term exposure to ozone can cause morbidity in individuals with asthma, and suggest that ozone exposures below the current U.S. EPA standard may be associated with increased SABA use.
Authors: Agnieszka Dawczak-Dębicka; Joanna Kufel-Grabowska; Mikołaj Bartoszkiewicz; Adrian Perdyan; Jacek Jassem Journal: Int J Environ Res Public Health Date: 2022-04-21 Impact factor: 4.614
Authors: Hua Hao; Sandrah P Eckel; Anahita Hosseini; Eleanne D S Van Vliet; Eldin Dzubur; Genevieve Dunton; Shih Ying Chang; Kenneth Craig; Rose Rocchio; Theresa Bastain; Frank Gilliland; Sande Okelo; Mindy K Ross; Majid Sarrafzadeh; Alex A T Bui; Rima Habre Journal: Int J Environ Res Public Health Date: 2022-03-17 Impact factor: 3.390