Indoor air pollution and respiratory health effects in inner city children with moderate to severe asthma

Indoor air pollution is increasingly recognized as a significant risk for respiratory illness, particularly in vulnerable populations. Thirty-six children aged 6–14 years with moderate/severe asthma from inner city areas in New York City were studied for 2-week periods (summer and winter) using diaries and spirometry. Seven-day integrated indoor samples of PM₁₀, PM_2.5, trace elements, elemental/organic carbon, black carbon, and criteria gases (NO₂, SO₂, and O₃) were collected in the subjects’ residences. Asthma outcomes included cough and wheeze severity, albuterol use, and pulmonary function. Mixed effects regression models for longitudinal data were used to relate weekly indoor pollutant concentrations to asthma outcomes. Odds ratios (ORs) were calculated for ordinal outcomes. During winter, significant positive associations for average weekly symptom severity scores were seen for NO₂ (OR = 2.83; p = 0.02), calcium (OR = 3.29; p = 0.02), and silicon (OR = 3.64; p = 0.04). In summer, chlorine was associated with average weekly symptom scores (OR = 1.85; p = 0.004). Average albuterol puff use per day in winter was associated with NO₂ (OR = 5.89; p = 0.009), nickel (OR = 2.27; p = 0.05), and silicon (OR = 5.59; p = 0.05). Albuterol use was not associated with indoor pollutants in summer. Asthma severity was associated with specific indoor pollutants. Seasonal differences were observed by pollutant and by clinical index studied.