Effect of Outdoor Air Pollution (OAP) on Pediatric Asthma Outcomes in Pittsburgh
Sunday, March 4, 2018: 3:00 PM
S310GH (Convention Center)
Deborah A. Gentile, MD, , , , ,
RATIONALE: OAP contributes to poor asthma outcomes and remains a public health issue in Pittsburgh. The purpose of this study was to determine the prevalence of childhood asthma and its rate of control among Pittsburgh schoolchildren residing near point sources of OAP.

METHODS: Participants were recruited from schools near OAP point sources. Asthma prevalence and control were assessed using a validated survey. Demographics and socioeconomic status were collected by survey, BMI was calculated, environmental tobacco smoke (ETS) was assessed by salivary cotinine levels, and OAP was assessed by mobile platform monitoring. Multivariate analysis adjusted for confounders.

RESULTS: 1,207 participated (mean age 8.5 +/- 1.9 years; 49.1% male). 52.2% were African American and 60.6% had public health insurance. Prevalence of physician diagnosed asthma was 22.5% and 59.3% of those were not well controlled. The mean linear distance from nearest OAP point source was 2.2 miles and 82.3% resided at least partially in the path of prevailing wind. 17.1% were obese and 33.9% had ETS. Odds ratio (OR) of physician diagnosed asthma were significantly elevated in males (1.4; p=0.04), African Americans (1.8; p=0.002), and those exposed to PM2.5 >10 ug/m3 (1.6; p=0.047). OR of uncontrolled asthma was 4.8 (p=0.014) in those exposed to PM2.5 >10 ug/m3. Obesity and ETS did not have a significant effect on OR.

CONCLUSIONS: Asthma prevalence and poor control are significantly elevated in Pittsburgh schoolchildren exposed to OAP. Future efforts need to focus on primary prevention of asthma by reducing exposure to OAP.