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Neighborhood air pollution and household environmental health as it relates to respiratory health and healthcare utilization among elderly persons with asthma
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA.ORCID iD: 0000-0001-7173-4333
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA.ORCID iD: 0000-0002-0471-8701
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2020 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 57, no 1, p. 28-39Article in journal (Refereed) Published
Abstract [en]

Objective: The study investigated the associations between fine particulate matter (PM2.5; <2.5 mu m in diameter), indoor environment, pulmonary function, and healthcare utilization in a vulnerable group of elderly persons with asthma. We hypothesized that environmental conditions were associated with adverse pulmonary health outcomes.

Methods: The study involved elderly (n = 76; mean age 64.6 years; 48 women) vulnerable persons in Detroit, Michigan, USA, with physician-diagnosed asthma. Exposure variables included measured outdoor PM2.5, self-rated outdoor and household environmental pollutants. Outcome variables were self-rated and measured pulmonary function, and asthma-related healthcare utilization.

Results: Mean ambient PM2.5 concentrations during the study was 14.14 +/- (S.D. 6.36) mu g/m(3) during the summer and 14.20 (6.33) during the winter (p = 0.95). In multiple regression analyses, adjusting for age and gender, mean 6-month concentration of PM2.5 was related to shortness of breath (SHOB; standardized beta = 0.26, p = 0.02) and inversely with self-rated respiratory health (SRRH; beta = 0.28, p = 0.02). However, PM2.5 did not predict lung function (FEV1% predicted and FEV1/FVC). However, PM2.5 was related to use of asthma controller drugs (beta = 0.38, p = 0.001). Participants' air pollution ratings predicted total healthcare utilization (beta = 0.33, p = 0.01).

Conclusions: In elderly persons with asthma, living near heavy industry and busy highways, objective and perceived environmental pollution relate to participants' respiratory health and healthcare utilization. Importantly, air pollution might increase use of asthma controller drugs containing corticosteroids with implication for elderly persons' risk to develop osteoporosis and cardiovascular disease.

Place, publisher, year, edition, pages
Taylor & Francis, 2020. Vol. 57, no 1, p. 28-39
Keywords [en]
Environmental exposures, pulmonary function, asthma exacerbation, asthma drug use
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-167354DOI: 10.1080/02770903.2018.1545856ISI: 000505124800004PubMedID: 30810414OAI: oai:DiVA.org:umu-167354DiVA, id: diva2:1387845
Available from: 2020-01-22 Created: 2020-01-22 Last updated: 2020-01-22Bibliographically approved

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Arnetz, BengtArnetz, Judy

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