Monitoring air pollution and pulmonary function in asthmatic children by mobile applications in COVID-19 pandemic (Preprint)

Abstract

BACKGROUND Several public health measures were implemented during the COVID-19 pandemic. However, little is known about the real-time assessment of environmental exposure on the pulmonary function of asthmatic children. OBJECTIVE We developed a mobile phone application to capture real-time day-to-day dynamic air pollution changes during the pandemic METHODS A prospective cohort study was conducted among 511 asthmatic children under visit at Taipei City Hospital from January 2016 to February 2022. Ambient air pollution PM2.5, PM10, O3, NO2, CO, and SO2, daily average temperature, and relative humidity are measured from 77 nearby air monitoring stations by linking to Global Positioning System (GPS)-based software. The outcome of pollutants' effect on peak expiratory flow meter (PEF) and asthma is measured by a smart peak flow meter from each patient or caregiver's phone for real-time assessment. RESULTS The lockdown (May 19th, 2021, to July 27th, 2021) was associated with decreased levels of all air pollutants aside from SO2 after adjusting for the year 2021. NO2 and SO2 were constantly associated with decreased levels of PEF across lag 0 to lag 2. PM10 was associated with lower levels of PEF at lag 0 (-0.44, 95%CI: -0.77 to -0.10, P=.030) and lag 2 (-0.39, 95%CI: -0.76 to -0.02, P=.023). CO was associated with decreased levels of PEF only at day 0 (-49.0, 95%CI: -77.97 to -18.33, P=.008) and at day 1 (-43.1, 95%CI: -71.81to -14.34, P=.099). CONCLUSIONS Using our developed smartphone apps, we identified that NO2, CO, and PM10 were higher at the pre-and post-COVID-19 lockdowns than during the lockdown. Our smartphone apps may be useful for collecting personal air pollution data and lung function, especially for asthmatic patients, and may guide protection against asthma attacks. It provides a new model for individualized care in the COVID era and beyond.