Pilot Study Identifies Obesity, Outdoor Air Pollution, and Tobacco Smoke Exposure As Contributors to High Estimated Prevalence of Risk of Asthma in Inner-City Schoolchildren from Pittsburgh Region

Rationale: Pediatric asthma is a public health concern in the inner-city of Pittsburgh. The purpose of this pilot study was to develop efficient and accurate methods to assess the prevalence of asthma among schoolchildren in Pittsburgh.

Methods: This study was approved by the Allegheny Singer Research Institute-Allegheny Health Network Institutional Review Board. Informed consent/assent was obtained from all subjects prior to participation. Fifth grade students were recruited from twelve Pittsburgh schools.   Estimated prevalence was calculated for those subjects at risk for asthma and those previously diagnosed with asthma.  Relationships between contributors, including poverty (public health insurance), outdoor air pollution (PM2.5),  tobacco smoke exposure (salivary cotinine), psychological stress (salivary cortisol), and obesity (BMI) were explored using logistic regression analyses.    

Results: 267 subjects were enrolled (37.5% African American (AA), 41.6% female,  44.2% public insurance).  Results demonstrate that 40.4% of subjects were at risk of asthma, 28.7% had a previous diagnosis and 11.7% were newly identified.  Subjects at highest risk of asthma were those overweight (OR= 2.0; p=0.39)) or obese (OR= 2.8; p =0.002), exposed to above average levels of PM2.5 (OR 3.2, p=0.10) , and exposed to tobacco smoke (OR 2.2, p=0.56). 

Conclusions: Results indicate a high estimated prevalence of risk of asthma among participants.  Obesity, outdoor air pollution and tobacco smoke exposure were identified as contributors.  Future studies need to expand upon this sample size, and ultimately improve asthma outcomes in at-risk populations.