Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health record
- PDF / 2,841,842 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 89 Downloads / 170 Views
RESEARCH ARTICLE
Open Access
Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data Jingyi He1, Mohsen Ghiasi Ghorveh2, Jillian H. Hurst3,4, Monica Tang5, Brooke Alhanti2, Jason E. Lang2,4 and Benjamin A. Goldstein1,2,3,4*
Abstract Background: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods: To evaluate the impact of highway proximity, we assessed the association between asthma exacerbations and the distance of child’s primary residence to two types of roadways in Durham County, North Carolina, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6208 children with asthma between 2014 and 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results: There was a no observed effect of residential distance from 55+ MPH highway (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)) and distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)) and any asthma exacerbation. Even those children living closest to highways (less 0.25 miles) had no increased risk of exacerbation. These results were consistent across different demographic strata. Conclusions: While the results were non-significant, the characteristics of the study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to the lack of effect. Compared to previous studies, which often relied on self-reported measures, we were able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts on disease. Keywords: Air pollution, Asthma, Electronic health records, Survival analysis
* Correspondence: [email protected] 1 Department of Biostatistics & Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC 27705, USA 2 Duke Clinical Research Institute, Durham, NC, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence,
Data Loading...
