Heavy precipitation and asthma exacerbation risk among children: A case-crossover study using electronic health records linked with geospatial data

Schinasi, Leah H.; Kenyon, Chén C.; Moore, Kari; Melly, Steve; Zhao, Yongfeng; Hubbard, Rebecca A.; Maltenfort, Mitch; Roux, Ana V. Diez; Forrest, Christopher B.; Roos, Anneclaire J. De

doi:10.1016/j.envres.2020.109714

Cited by 9 publications

(17 citation statements)

References 27 publications

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“…Although the proportion of patients reporting weather changes as a trigger also did not differ by sex, age, or geographical location in our study, weather changes had effects on asthma attacks. Previous studies found that temperature changes and heavy precipitation were associated with asthma attacks (39,40). A study in Shanghai found that regardless of the cold or warm season, high diurnal temperature differences, low relative humidity, and wind speed were all associated with a high risk of acute asthma exacerbation in children (41).…”

Section: Weather Changesmentioning

confidence: 96%

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

2021

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Background: Asthma can be exacerbated by many triggers, and the heterogeneity of asthma triggers is clear among children with asthma. This study describes asthma triggers using a large-scale electronic dataset from the smartphone-based Chinese Children's Asthma Action Plan (CCAAP) app and aims to examine the difference in asthma triggers among different subgroups of children with asthma.Methods: Data from the smartphone-based CCAAP app between February 22, 2017, and November 23, 2020, were reviewed, and children with asthma who reported their asthma triggers were enrolled. Eight common asthma triggers were listed in the software: upper respiratory infection (URI), allergen sensitization, exercise, emotional disturbances, pungent odors, air pollution/smog, weather change, and tobacco smoke. We compared the incidence of asthma triggers among different subgroups (<6 years vs. 6–17 years; boy vs. girl; eastern region vs. central region vs. western region).Results: We enrolled 6,835 patients with self-reported asthma triggers. When compared by sex, boys had a higher proportion of exercise-triggered asthma than girls (boys vs. girls, 22.5 vs. 19.7%, p < 0.05). The proportion of patients <6 years of age with URI-triggered asthma was higher than that of patients 6–17 years of age (<6 vs. 6–17 years, 80.9 vs. 74.9%, p < 0.001). Patients 6–17 years of age were more likely than patients <6 years of age to report five of the asthma triggers: allergen sensitization (<6 vs. 6–17 years, 26.6 vs. 35.8%, p < 0.001), exercise (<6 vs. 6–17 years, 19.3 vs. 23.7%, p < 0.001), pungent odors (<6 vs. 6–17 years, 8.8 vs. 12.7%, p < 0.001), air pollution/smog (<6 vs. 6–17 years, 9.4 vs. 16.2%, p < 0.001), and tobacco smoke (<6 vs. 6–17 years, 3.5 vs. 5.3%, p < 0.001). In subgroups based on geographical distribution, asthma triggering of allergen sensitization was reported to be the most common in patients from the eastern region (eastern region vs. central region vs. western region, 35.0 vs. 24.6 vs. 28.0%, p < 0.001). Exercise-triggered asthma was found to be the most prevalent among patients from the central region (eastern region vs. central region vs. western region, 21.6 vs. 24.8 vs. 20.4%, p < 0.05). However, the proportion of patients with air pollution/smog as an asthma trigger was the lowest among those from the western region (eastern region vs. central region vs. western region, 14.1 vs. 14.1 vs. 10.8%, p < 0.05).Conclusion: Children with asthma present different types of asthma triggers, both allergenic and nonallergenic. Age, sex, and geographical distribution affect specific asthma triggers. Preventive measures can be implemented based on a patient's specific asthma trigger.

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Section: Weather Changesmentioning

confidence: 96%

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

2021

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“…Four papers used a clinically significant asthma exacerbation as an outcome [52][53][54][55][56]. Schinasi et al found that odds of asthma exacerbation in children were 11% higher on heavy precipitation versus no precipitation days with 95% CI: (1.02-1.21) [52]. They defined heavy precipitation days as days with >95th percentile precipitation.…”

Section: Outcomes and Study Populationsmentioning

confidence: 99%

“…Study population ages and locations were varied among papers. Four papers studied children [52,53,55,61]. Brokamp One study in Japan on typhoons and asthma exacerbations studied a population of persons with asthma who were currently undergoing treatment at the time of study [62].…”

Section: Outcomes and Study Populationsmentioning

confidence: 99%

“…The Fuhlbrigge reference appears to be a standard definition. One paper used this definition for their cases [52].…”

Section: Case Definitionsmentioning

confidence: 99%

“…Brokamp et al defined cases as ED visits with a primary diagnosis using ICD-9 [55], while Chowdhury et al defined ED visits with the ICD-10 classification [54]. One paper used both the ICD-9 and ICD-10 systems [52]. Cowan et al conducted a record review of ED visits and inpatient visits with asthma as the primary diagnosis using ICD-9 [56].…”

Section: Case Definitionsmentioning

confidence: 99%

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Climate Change Related Catastrophic Rainfall Events and Non-Communicable Respiratory Disease: A Systematic Review of the Literature

Peirce

Espira

Larson

2022

Climate

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Climate change is increasing the frequency and intensity of extreme precipitation events, the impacts of which disproportionately impact urban populations. Pluvial flooding and flooding related sewer backups are thought to result in an increase in potentially hazardous human-pathogen encounters. However, the extent and nature of associations between flooding events and non-communicable respiratory diseases such as chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are not well understood. This research seeks to characterize the state of research on flooding and NCRDs through a systematic review of the scientific literature. We conducted a systematic search of PubMed, Web of Science, and Scopus for published scholarly research papers using the terms flooding, monsoon, and tropical storm with terms for common NCRDs such as asthma, COPD, and chronic bronchitis. Papers were included if they covered research studies on individuals with defined outcomes of flooding events. We excluded review papers, case studies, and opinion pieces. We retrieved 200 articles from PubMed, 268 from Web of Science and 203 from Scopus which comprised 345 unique papers. An initial review of abstracts yielded 38 candidate papers. A full text review of each left 16 papers which were included for the review. All papers except for one found a significant association between a severe weather event and increased risk for at least one of the NCRDs included in this research. Our findings further suggest that extreme weather events may worsen pre-existing respiratory conditions and increase the risk of development of asthma. Future work should focus on more precisely defining measure of health outcomes using validated tools to describe asthma and COPD exacerbations. Research efforts should also work to collect granular data on patients’ health status and family history and assess possible confounding and mediating factors such as neighborhood water mitigation infrastructure, housing conditions, pollen counts, and other environmental variables.

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The impact of climate change on respiratory care: A scoping review

Lewy,

Karim,

Lokotola

et al. 2024

The Journal of Climate Change and Health

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Heavy precipitation and asthma exacerbation risk among children: A case-crossover study using electronic health records linked with geospatial data

Cited by 9 publications

References 27 publications

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

Climate Change Related Catastrophic Rainfall Events and Non-Communicable Respiratory Disease: A Systematic Review of the Literature

The impact of climate change on respiratory care: A scoping review

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