Obesity may enhance the adverse effects of NO2 exposure in urban schools on asthma symptoms in children - 05/10/20
Abstract |
Background |
Sparse data address the effects of nitrogen dioxide (NO2) exposure in inner-city schools on obese students with asthma.
Objective |
We sought to evaluate relationships between classroom NO2 exposure and asthma symptoms and morbidity by body mass index (BMI) category.
Methods |
The School Inner-City Asthma Study enrolled students aged 4 to 13 years with asthma from 37 inner-city schools. Students had baseline determination of BMI percentile. Asthma symptoms, morbidity, pulmonary inflammation, and lung function were monitored throughout the subsequent academic year. Classroom NO2 data, linked to enrolled students, were collected twice per year. We determined the relationship between classroom NO2 levels and asthma outcomes by BMI stratification.
Results |
A total of 271 predominantly black (35%) or Hispanic students (35%) were included in analyses. Fifty percent were normal weight (5-84th BMI percentile), 15% overweight (≥85-94th BMI percentile), and 35% obese (≥95th BMI percentile). For each 10-parts per billion increase in NO2, obese students had a significant increase in the odds of having an asthma symptom day (odds ratio [OR], 1.86; 95% CI, 1.15-3.02) and in days caregiver changed plans (OR, 4.24; 95% CI, 2.33-7.70), which was significantly different than normal weight students who exhibited no relationship between NO2 exposure and symptom days (OR, 0.90; 95% CI, 0.57-1.42; pairwise interaction P = .03) and change in caregiver plans (OR, 1.37; 95% CI, 0.67-2.82; pairwise interaction P = .02). Relationships between NO2 levels and lung function and fractional exhaled nitric oxide did not differ by BMI category. If we applied a conservative Holm-Bonferroni correction for 16 comparisons (obese vs normal weight and overweight vs normal weight for 8 outcomes), these findings would not meet statistical significance (all P > .003).
Conclusions |
Obese BMI status appears to increase susceptibility to classroom NO2 exposure effects on asthma symptoms in inner-city children. Environmental interventions targeting indoor school NO2 levels may improve asthma health for obese children. Although our findings would not remain statistically significant after adjustment for multiple comparisons, the large effect sizes warrant future study of the interaction of obesity and pollution in pediatric asthma.
Il testo completo di questo articolo è disponibile in PDF.Key words : Asthma, obesity, body mass index, BMI, inner-city, urban, school, nitrogen dioxide, NO2, children, environment, exposure, indoor, pollutant, air
Abbreviations used : BMI, Feno, FVC, NO, NO2, OR, ppb, SICAS
Mappa
| This research is supported by the National Institutes of Health (grant nos. R01 AI 073964, U01 AI 110397, and K24 AI 106822 [PI, W.P.], grant no. K23 AI 123517 [PI, P.P], grant no. R01 ES 030100 [PI, J.M.G.], grant no. R01 AI 144119 [PI, P.S.L.], and grant no. K23 AI 104780 [PI, W.J.S.]). Funding was provided by The Allergy and Asthma Awareness Initiative, Inc. This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the National Institutes of Health. |
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| Disclosure of potential conflict of interest: W. Phipatanakul is a consultant advisory for Teva, Genentech, Novartis, GlaxoSmithKline, and Regeneron, for asthma-related therapeutics. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 146 - N° 4
P. 813 - Ottobre 2020 Ritorno al numero
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