Parental knowledge and usage of air quality in childhood asthma management

Abstract

BackgroundThe current United States asthma management guidelines recommend usage of the Air Quality Index (AQI) for outdoor activity modification when air pollution is high. Little is known about parental knowledge and usage of air quality including the AQI in managing childhood asthma.MethodsForty parents (or legal guardians) of children with persistent asthma completed a questionnaire designed to assess 4 areas related to outdoor air pollution: awareness, perception, behavioral modification, and prior healthcare provider discussion. Descriptive statistics were obtained and Fisher's exact test was used for analysis of behavioral change by selected variables.ResultsAlmost all parents reported awareness of air quality alerts or AQI, however, only 20% checked the AQI on the AirNow app or website. Most parents reported air pollution as a trigger (65%), yet few parents reported behavioral modification of their child's outdoor activity based on the perception of poor air quality (43%) or based on AQI or alerts (40%). Over half of parents reported a healthcare provider had ever discussed air pollution as a trigger, with few parents (23%) reporting recommendations for behavior change. Perception of air pollution as a trigger, healthcare provider discussion and recommendations, and usage of AirNow were associated with increased reported activity change.ConclusionHealthcare providers should discuss outdoor air pollution during asthma management in children and should discuss AirNow as a source for AQI information and behavioral recommendations.

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

“…For an air quality index to be effective at preventing adverse health outcomes, several tenets are required: the index, derived from pollutant concentrations, should be associated with the health outcomes it seeks to prevent; the index must be easily understood and widely accessible to people; persons must be aware of the index including how and when to use and respond; persons must be motivated and able to implement the response; and the response should result in reduced exposure and therefore reduction of adverse health outcomes 125–127 . Few studies have been conducted in children with respiratory disease for any of these components 126,128–136 …”

“…Most studies support provider discussion is associated with increased usage of the AQI. 136,138,139 As a recent study demonstrated an association with nonviral triggered asthma exacerbations and levels of ozone below which AQI alerts would be issued, 93 using the AQI as a way to learn personal susceptibilities in conjunction with responding to alerts may be a preferable strategy. Based on a small randomized clinical trial of adding the AQI to childhood asthma action plans 135 and from the known benefits of physical activity, we recommend clinicians monitor physical activity closely in children with respiratory disease using the AQI to learn personal ozone susceptibilities.…”

“…Until such time as high‐quality clinical algorithms, based on evidence, are available, it remains appropriate to educate families and children with respiratory disease of the use of AirNow as a method to reduce short‐term outdoor ozone exposure (Table 4). Most studies support provider discussion is associated with increased usage of the AQI 136,138,139 …”

“…[125][126][127] Few studies have been conducted in children with respiratory disease for any of these components. 126,[128][129][130][131][132][133][134][135][136] Until such time as high-quality clinical algorithms, based on evidence, are available, it remains appropriate to educate families and children with respiratory disease of the use of AirNow as a method to reduce short-term outdoor ozone exposure (Table 4). Most studies support provider discussion is associated with increased usage of the AQI.…”