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Air Pollution and Asthma Outcomes: Using an asthma registry and electronic medical records to compose environmental health studies

Byrwa-Hill, Brandy M (2022) Air Pollution and Asthma Outcomes: Using an asthma registry and electronic medical records to compose environmental health studies. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Asthma is a heterogeneous disease with variable severity and clinical presentation that may be exacerbated by environmental factors, such as air pollution.(1-5) Allegheny County PA estimated asthma rates are higher than the national average, with estimates for adults at 10%, 6 and children 11%.7 We used a combination of electronic medical records (EMR) and data from an established asthma registry to study associations of asthma control and severity with air pollution.
The objective of these studies was to examine the associations between asthma severity and control of air pollution and socioeconomic factors. Our primary hypothesis states “Asthma control and severity will be worsened by exposure to air pollutants and factors associated with environmental justice areas.” The aim of the current study was, therefore, (i) to establish the prevalence of asthma exacerbations concerning acute pollutant exposures within patients who reside in Allegheny County (ii) to determine whether specific socio-demographic variables and chronic air pollution events are associated with poor asthma control and severity within patients from an asthma research registry; and (iii) to examine the association of asthma and acute air pollution exposure after a factory fire that occurred near residential homes.
We devised epidemiological studies that used descriptive and inferential statistics comparing odds ratios and generalized linear regression models to examine the relationships between variables of interest in acute and chronic air pollution exposure and EJ factors.
Strengths of this research reveal: (i) an association between O3 exposure in children and NO2 and CO exposure in adults with asthma-related ED visits within the greater Pittsburgh area; (ii) Severe asthma patients living in areas with the highest NO2 exposure had increased odds of uncontrolled asthma (not observed in milder patients), and disease duration was associated with uncontrolled asthma for patients living in EJ areas; and (iii) a novel association between acute real-world exposures to increased SO2 and worsened asthma control in a vulnerable population living close to the source of pollution.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Byrwa-Hill, Brandy Mbmh113@pitt.edubmh113
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairLeikauf,
Committee MemberWenzel, Sallyswenzel@pitt.eduswenzel
Committee MemberFabisiak, Jimfabisiak@pitt.edufabisiak
Committee MemberPresto,
Committee MemberTalbott, Evelyntalbott@pitt.edutalbott
Date: 16 May 2022
Date Type: Publication
Defense Date: 17 November 2021
Approval Date: 16 May 2022
Submission Date: 19 April 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 148
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Environmental and Occupational Health
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Asthma, Air Pollution, Severe Asthma, Environmental Health, Asthma Control
Date Deposited: 16 May 2022 20:48
Last Modified: 16 May 2022 20:48


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