Heavy precipitation and asthma exacerbation risk among children: A case-crossover study using electronic health records linked with geospatial data.

TitleHeavy precipitation and asthma exacerbation risk among children: A case-crossover study using electronic health records linked with geospatial data.
Publication TypeJournal Article
Year of Publication2020
AuthorsSchinasi LH, Kenyon CC, Moore K, Melly S, Zhao Y, Hubbard R, Maltenfort M, Roux AVDiez, Forrest CB, De Roos AJ
JournalEnviron Res
Volume188
Pagination109714
Date Published2020 Jun 04
ISSN1096-0953
Abstract

Extreme precipitation events may be an important environmental trigger for asthma exacerbations in children. We used a time stratified case-crossover design and data from a large electronic health record database at the Children's Hospital of Philadelphia (CHOP) to estimate associations of daily heavy precipitation (defined as > 95th percentile of the summertime distribution) with asthma exacerbation among children. We defined control days as those falling on the same day of the week within the same month and year as the case. We restricted our primary analyses to the summer months in years 2011-2016 and used conditional logistic regression models to estimate associations between heavy precipitation and acute asthma exacerbations in both outpatient (primary care, specialty care, and emergency department) and inpatient settings. We investigated numerous individual-level (e.g., age, sex, eczema diagnosis) and environmental measures (e.g., greenspace, particulate matter) as potential effect modifiers. The analysis include 13,483 asthma exacerbations in 10,434 children. Odds of asthma exacerbation were 11% higher on heavy precipitation vs. no precipitation days (95% CI: 1.02-1.21). There was little evidence of effect modification by most measures. These results suggest that heavy summertime precipitation events may contribute to asthma exacerbations. Further research using larger datasets from other health systems is needed to confirm these results, and to explore underlying mechanisms.

DOI10.1016/j.envres.2020.109714
Alternate JournalEnviron. Res.
PubMed ID32559685
Grant ListK23 HL136842 / HL / NHLBI NIH HHS / United States