Can Children with Asthma Improve Control by Understanding and Using the Air Quality Index as a Component of Their Disease Management?

Air pollution can impart significant challenges on children and adults with asthma or other lung conditions in managing their condition and keeping acute attacks or symptom exacerbations at low levels.

Poor air quality and high pollution levels are generally more prevalent in urban areas due to higher concentrations of traffic, industrial activities, and other pollution sources. As a result, individuals living in cities are often at a higher risk of experiencing asthma-related issues caused by air pollution. Minoritized and lower-income or disadvantaged communities are disproportionately affected by poor air quality and air pollution. Due to historical and present structural racism and exclusionary policies, persons of color and persons under-resourced often reside in areas with higher pollution levels. Consequently, such persons face greater exposure to air pollutants and an increased risk of developing or worsening asthma and other respiratory conditions. Inequitable healthcare , including access, can further exacerbate the impact of air pollution on overall health.

A new pilot study published in the American Journal of Preventive Medicine from the UPMC Children’s Hospital of Pittsburgh Division of Pediatric Pulmonary Medicine sought to understand whether children with asthma who incorporated the use and understanding of the Air Quality Index into the management of their condition could improve their control and experience of symptoms.

Franziska Rosser, MD, MPH, FAAP, ATSF, assistant professor of Pediatrics, was the study’s lead author. Dr. Rosser’s research focuses on the epidemiological effects of outdoor air pollution on children with asthma while working to develop innovative methods to identify children with asthma most at risk of the deleterious effects of air pollution.

What is the AQI?

The Air Quality Index (AQI) provides information about air pollution levels and potential accompanying health risks. It is widely used in the United States to relay information to people about the air quality in their area using a simple, easily understandable color-coded scale representing how clean or polluted the air is on a given day or time of day and the potential health impacts associated with spending time exposed to the condition.

The AQI is divided into several categories, each corresponding to a specific color and level of health concern associated with exposure to the air in these conditions. By checking the AQI regularly, individuals can make informed decisions about outdoor activities, particularly those with respiratory conditions like asthma, to reduce their exposure to air pollution and minimize its health impacts.

Study Overview and Significant Clinical Findings

Dr. Rosser and colleagues' investigation aimed to deduce whether including information about air quality and related recommendations in management plans for children with asthma could help reduce acute attacks and improve overall quality of life.

The pilot study enrolled 40 children of varying ages with asthma. The study cohort was divided into two groups, with both receiving asthma action plans and education about air quality. The intervention group also received printed air quality information and learned how to use the AirNow website and its data.

Dr. Rosser’s study team monitored the children for asthma symptoms, how well they managed their asthma, and their quality of life. Study participants were followed for six months, with an analysis comparing outcomes between the groups.

At the end of the study, more children in the intervention group were found to have checked air quality information (63% vs. 15%). However, there were no differences in the number of asthma attacks or in asthma quality of life.

The intervention group did, however, show a higher average improvement in asthma management scores, which changed over time. Interestingly, overall physical activity decreased for all participants in the study but more so for children in the intervention. As very few days during the study were in the orange zone or above, for which physical activity reduction is appropriate, more research is needed as physical activity is an important part of overall health.

Read more about the study using the reference link below.

Read more about Dr. Rosser and her research.

Reference

Rosser FJ, Rothenberger SD, Han YY, Forno E,Celedón JC. Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention. Am J Prev Med. 2023 Jan 13: S0749-3797(22)00574-8. doi: 10.1016/j.amepre.2022.12.010. Online ahead of print.