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Air Pollution Influences Asthma Control in an Urban Adult Asthma Population
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A2807 - Air Pollution Influences Asthma Control in an Urban Adult Asthma Population
Author Block: J. Jomi, U. Mehta, S. Melly, J. F. Most; Drexel University, Philadelphia, PA, United States.
RATIONALE: Philadelphia has the highest prevalence of asthma and the highest asthma related mortality in the state of Pennsylvania. Air pollution is thought to play a role in asthma control. We aim to determine if air pollution including NOx, PM 2.5 and SO2 impacted asthma control in those patients with persistent asthma living in Philadelphia.
METHODS: This is a retrospective cross-sectional study including all individuals living in Philadelphia and over the age of 17 seen at a large University practice with persistent asthma who had an Asthma Control Test (ACT). This objective measure of asthma control was instituted as a standard measure in all practices in 2014. The diagnosis of persistent asthma was based on physician billing and presence of a controller medication. All individuals with a concomitant lung disease including: COPD, cystic fibrosis, interstitial lung disease, pulmonary hypertension, asbestosis, and sarcoidosis were excluded. Subject were geocoded using their current address and ArcGISPro 1.4 software to then assign them concentrations of air pollutants including: PM2.5, SO2, and NOx using the National Emissions Inventory dataset. Association between asthma control and air pollution was calculated using multivariate logistic regression analysis.
RESULTS: Of 465 patients, 277 (59.6%) had poorly controlled asthma as defined by an ACT ≤ 19. The cohort was predominantly women 351 (75%) and African-American 290 (62.3%). 139 (29.4%) were current smokers and 230 (49.4%) were classified as obese (BMI ≥ 30). There were no significant differences in demographics between the well controlled and poorly controlled including: smoking status, race/ethnicity, obesity, gender, age, or insurance status. On multivariate analysis PM2.5 and SO2 concentrations within 1 kilometer (km) were associated with an increased risk of poor asthma control, OR 1.908 (CI 1.064 - 3.423) and 1.967 (CI 1.087 - 3.561) respectively. The OR for NOx and asthma control was 1.666 (CI 0.924 - 3.001). Concentrations of PM2.5, SO2, and NOx within 3 km were not associated with asthma control.
CONCLUSIONS: Asthma prevalence, hospitalization, and mortality is high in the city of Philadelphia. In this study, asthmatics who live in close proximity of high levels of SO2 and PM2.5 were more likely to have poorly controlled
asthma. Mediating the exposure of air pollutants in an Urban community may have important health impacts including improved asthma control, which may reduce asthma-related morbidity and mortality.
Author Block: J. Jomi, U. Mehta, S. Melly, J. F. Most; Drexel University, Philadelphia, PA, United States.
RATIONALE: Philadelphia has the highest prevalence of asthma and the highest asthma related mortality in the state of Pennsylvania. Air pollution is thought to play a role in asthma control. We aim to determine if air pollution including NOx, PM 2.5 and SO2 impacted asthma control in those patients with persistent asthma living in Philadelphia.
METHODS: This is a retrospective cross-sectional study including all individuals living in Philadelphia and over the age of 17 seen at a large University practice with persistent asthma who had an Asthma Control Test (ACT). This objective measure of asthma control was instituted as a standard measure in all practices in 2014. The diagnosis of persistent asthma was based on physician billing and presence of a controller medication. All individuals with a concomitant lung disease including: COPD, cystic fibrosis, interstitial lung disease, pulmonary hypertension, asbestosis, and sarcoidosis were excluded. Subject were geocoded using their current address and ArcGISPro 1.4 software to then assign them concentrations of air pollutants including: PM2.5, SO2, and NOx using the National Emissions Inventory dataset. Association between asthma control and air pollution was calculated using multivariate logistic regression analysis.
RESULTS: Of 465 patients, 277 (59.6%) had poorly controlled asthma as defined by an ACT ≤ 19. The cohort was predominantly women 351 (75%) and African-American 290 (62.3%). 139 (29.4%) were current smokers and 230 (49.4%) were classified as obese (BMI ≥ 30). There were no significant differences in demographics between the well controlled and poorly controlled including: smoking status, race/ethnicity, obesity, gender, age, or insurance status. On multivariate analysis PM2.5 and SO2 concentrations within 1 kilometer (km) were associated with an increased risk of poor asthma control, OR 1.908 (CI 1.064 - 3.423) and 1.967 (CI 1.087 - 3.561) respectively. The OR for NOx and asthma control was 1.666 (CI 0.924 - 3.001). Concentrations of PM2.5, SO2, and NOx within 3 km were not associated with asthma control.
CONCLUSIONS: Asthma prevalence, hospitalization, and mortality is high in the city of Philadelphia. In this study, asthmatics who live in close proximity of high levels of SO2 and PM2.5 were more likely to have poorly controlled
asthma. Mediating the exposure of air pollutants in an Urban community may have important health impacts including improved asthma control, which may reduce asthma-related morbidity and mortality.
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