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

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

Leah H. Schinasi, Chén C. Kenyon, Kari Moore, Steve Melly, Yuzhe Zhao, Rebecca Hubbard, Mitch Maltenfort, A.V. Diez Roux, Christopher B. Forrest and Anneclaire J. De Roos
Environmental research, v 188, 109714
Sep 2020
DOI: https://doi.org/10.1016/j.envres.2020.109714
PMID: 32559685
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Asthma Asthma exacerbation Climate Environment Precipitation Rainfall
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. •Heavy precipitation events were associated with higher odds of asthma exacerbation among children.•Associations between heavy precipitation and asthma exacerbation were restricted to the summer months.•We used data from a large electronic health record database to quantify associations of daily heavy precipitation with asthma exacerbation among children.

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13 citations in Web of Science
15 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Environmental Sciences
Public, Environmental & Occupational Health
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