Air Pollutants and Asthma Hospitalization in the Medicaid Population

Wei, Yaguang; Qiu, Xinye; Sabath, Matthew Benjamin; Yazdi, Mahdieh Danesh; Yin, Kanhua; Li, Longxiang; Peralta, Adelqui; Wang, Cuicui; Koutrakis, Petros; Zanobetti, Antonella; Dominici, Francesca; Schwartz, Joel

doi:10.1164/rccm.202107-1596oc

Cited by 22 publications

(16 citation statements)

References 31 publications

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“…In subgroup analysis by age, the association with O 3 was greatest for teens aged 13–18 years old (43%, 95%CI 21%–65%) but not seen for children 12 years and younger. In a cohort sub‐analysis, the association between O 3 exposure and risk was observed at 8‐h maximum mean levels <70 ppb (12% increased risk, 95 CI 7%–17%) and <60 ppb (10% increased risk, 95% CI 4%–16%), and was higher among persons residing in zip codes with higher neighborhood disadvantage and lower population density 47 . Another study found associations between ozone and childhood asthma emergency department visits, even at cold season 8‐h maximum average ozone levels between 39 and 51 ppb 84 …”

Section: Current Ozone Naaqs Is Not Adequatementioning

confidence: 94%

“…A nationwide study of adults and children receiving Medicaid found every 1 ppb increase in short term warm‐season O 3 was associated with a 10% increased risk of asthma hospitalizations 47 . In subgroup analysis by age, the association with O 3 was greatest for teens aged 13–18 years old (43%, 95%CI 21%–65%) but not seen for children 12 years and younger.…”

Section: Current Ozone Naaqs Is Not Adequatementioning

confidence: 98%

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Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Rosser

Balmes

2023

Pediatric Pulmonology

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Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.

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Section: Current Ozone Naaqs Is Not Adequatementioning

confidence: 94%

Section: Current Ozone Naaqs Is Not Adequatementioning

confidence: 98%

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Rosser

Balmes

2023

Pediatric Pulmonology

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“…As a highly oxidizing and reactive gas, inhaled ozone is considered to be one of toxicants for the respiratory tract, which has been linked to a variety of adverse respiratory outcomes, such as a higher risk of respiratory mortality, increased incidence of respiratory diseases, and exacerbation of respiratory irritations (7,8). Previous epidemiological studies have investigated the associations between ozone pollution and acute asthma exacerbations (9)(10)(11). For example, a national study in US and multi-city studies in Texas have associated short-term ozone concentration with asthma hospitalization (10,12,13).…”

Section: Introductionmentioning

confidence: 99%

“…Previous epidemiological studies have investigated the associations between ozone pollution and acute asthma exacerbations (9)(10)(11). For example, a national study in US and multi-city studies in Texas have associated short-term ozone concentration with asthma hospitalization (10,12,13). Associations of ozone with asthma emergency room visits were also reported in many studies (14,15).…”

Section: Introductionmentioning

confidence: 99%

Short-term exposure to ozone and asthma exacerbation in adults: A longitudinal study in China

Fang

Huang²,

Zhu³

et al. 2023

Front. Public Health

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BackgroundThe relationships between short-term ozone exposure and the acute exacerbations of asthma in adults have not been fully studied. Existing studies commonly ignored the effects of ozone on mild or early asthma exacerbations.ObjectiveTo investigate the associations between short-term ozone exposure and asthma exacerbations in Chinese adults.MethodsWe administered health management for adult asthma patients through the Respiratory Home Platform and required them to monitor their lung function every morning and evening by themselves. Finally, a total of 4,467 patients in 18 Chinese cities were included in the current analyses, with 79,217 pairs of lung function records. The maximum daily 8-h average ozone concentrations were collected from fixed-site air quality monitoring stations. We calculated diurnal peak expiratory flow (PEF) variation using morning and evening measurements of PEF and then defined different severity of asthma exacerbations with diurnal PEF variations >10, 15, and 20%, respectively. A binomial distributed generalized additive mixture model combined with distribution non-linear models was applied to examine the association of ozone with asthma exacerbations. We further conducted stratified analyses by sex, age, season of lung function tests, and region.Measurements and resultsWe found that short-term ozone exposure was independently associated with an elevated risk of asthma exacerbations defined by lung function and the effects could last for about 2 days. At lag 0–2 days, each 10 μg/m3 increment in ozone concentration was associated with odds ratios of 1.010 [95% confidence interval (CI): 1.003, 1.017], 1.014 (95% CI: 1.005, 1.023), and 1.017 (95% CI: 1.006, 1.028) for asthma exacerbations that were defined by diurnal PEF variation over 10, 15, and 20%, respectively. The associations remained significant after adjusting for other pollutants, and became unstable when using 24-h average ozone concentration. We also found that the associations were relatively stronger in males, those aged 45 years and older, and in the warm season.ConclusionsOur results suggest that short-term ozone exposure can increase the risk of asthma exacerbations, even in the early stage of exacerbation. Male and older asthma patients may be more vulnerable to ozone air pollution, especially in the warm season.

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“…Hospitalizations for asthma can be triggered by various factors such as exposure to allergens, air pollution, respiratory infections, and poor management of the condition. [5] In some cases, hospitalization may be necessary to control severe asthma attacks, which can be life-threatening if not treated promptly. Asthma-related mortality is also a significant concern, with deaths resulting from severe asthma attacks.…”

Section: Introductionmentioning

confidence: 99%

Impact of Treatment on Asthma Control in Quetta Pakistan

Sehar¹,

Haq²,

Tahir³

et al. 2023

J. Pharm. Practice and Community Med.

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Background: Poorly controlled asthma may lead to decreased lung function, increase the risk of complications and more episodes of exacerbations, increased healthcare utilization, including more frequent hospitalizations and emergency room visits. Regular monitoring of asthma symptoms and lung function can help identify any potential issues in asthma control and ensure optimal management. Objectives:The study aims to assess the asthma control by the usage of asthma controller medications especially, corticosteroids, bronchodilators and leukotriene modifiers, among patients receiving treatment through well-validated questionnaire. Materials and Methods: A cross-sectional study with a sample of 361 was conducted in different public hospitals outpatient departments and clinics of Quetta Pakistan by using a convenience sampling technique. The Asthma Control Questionnaire (ACQ) was used to measure the asthma control of the asthmatic patients. The descriptive and inferential statistics have been done by using SPSS version 20 with a p value <0.05. Results: The study found that an average score of asthma control was 3.1±1.10 thereby indicating uncontrolled asthma with also 62.3% of study participants had uncontrolled asthma, no patient had controlled asthma. An increased number of medications including the use of corticosteroids and leukotriene modifiers posed an impact on asthma control of the study population. Conclusion:The study concluded that corticosteroids and leukotriene modifiers can be effective in asthma control and it is suggested for the future studies that route of administration and treatment guidelines must also be determined along with the asthma control to gain a complete picture of impact of treatment and management on any health outcomes.

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Air Pollutants and Asthma Hospitalization in the Medicaid Population

Cited by 22 publications

References 31 publications

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Short-term exposure to ozone and asthma exacerbation in adults: A longitudinal study in China

Impact of Treatment on Asthma Control in Quetta Pakistan

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