Can combined home and school traffic proximity worsen asthma morbidity?

Published online: September 23, 2019

Asthma is the most common non-communicable childhood disease, affecting approximately 8% of children and more than 6 million children in the United States with a rising prevalence worldwide. Urban minority children of low socioeconomic status endure disproportionately high asthma morbidity. Traffic proximity has been associated with adverse respiratory health outcomes. While the home environment has been extensively studied, many studies do not account for residential mobility or daily activity patterns (e.g. school location). Less is known about the combined impact of residential and school exposures, where children spend the majority of their day, on pediatric asthma.

In a research article recently published in the The Journal of Allergy & Clinical Immunology (JACI), Hauptman and colleagues theorized that a composite measurement accounting for both home and school exposure would be associated with worsened asthma morbidity. They used spatial analysis methodology to analyze residential and school proximity to major roadways and pediatric asthma morbidity in the School Inner-City Asthma Study, a five-year prospective cohort study of school-aged children with asthma attending urban public elementary schools in the northeastern United States from 2008-2013. The study participants had been followed longitudinally over an academic year approximately every 3 months and there was extensive longitudinal information, which included a detailed questionnaire, about asthma symptoms, healthcare utilization, medication use and adherence, home and school allergic and environmental risk factors, environmental exposure measurements, allergen sensitization skin and blood testing, and pulmonary function testing.

The authors found that proximity to major roadways, a composite measurement accounting for both home and school exposure, primarily driven by home proximity to major roadway was associated with increased asthma symptoms, health care utilization, and poor asthma control.
It is important for physicians to identify a child’s proximity to traffic into their clinical decision making in managing and preventing acute asthma exacerbations. Further studies are needed to better delineate the role of school traffic proximity adjusting for home exposures.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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