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Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data.

Publication ,  Journal Article
He, J; Ghorveh, MG; Hurst, JH; Tang, M; Alhanti, B; Lang, JE; Goldstein, BA
Published in: BMC Public Health
October 29, 2020

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.

Duke Scholars

Published In

BMC Public Health

DOI

EISSN

1471-2458

Publication Date

October 29, 2020

Volume

20

Issue

1

Start / End Page

1626

Location

England

Related Subject Headings

  • Vehicle Emissions
  • Public Health
  • North Carolina
  • Humans
  • Environmental Exposure
  • Electronic Health Records
  • Child
  • Asthma
  • Air Pollution
  • Air Pollutants
 

Citation

APA
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ICMJE
MLA
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He, J., Ghorveh, M. G., Hurst, J. H., Tang, M., Alhanti, B., Lang, J. E., & Goldstein, B. A. (2020). Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data. BMC Public Health, 20(1), 1626. https://doi.org/10.1186/s12889-020-09731-0
He, Jingyi, Mohsen Ghiasi Ghorveh, Jillian H. Hurst, Monica Tang, Brooke Alhanti, Jason E. Lang, and Benjamin A. Goldstein. “Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data.BMC Public Health 20, no. 1 (October 29, 2020): 1626. https://doi.org/10.1186/s12889-020-09731-0.
He J, Ghorveh MG, Hurst JH, Tang M, Alhanti B, Lang JE, et al. Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data. BMC Public Health. 2020 Oct 29;20(1):1626.
He, Jingyi, et al. “Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data.BMC Public Health, vol. 20, no. 1, Oct. 2020, p. 1626. Pubmed, doi:10.1186/s12889-020-09731-0.
He J, Ghorveh MG, Hurst JH, Tang M, Alhanti B, Lang JE, Goldstein BA. Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data. BMC Public Health. 2020 Oct 29;20(1):1626.
Journal cover image

Published In

BMC Public Health

DOI

EISSN

1471-2458

Publication Date

October 29, 2020

Volume

20

Issue

1

Start / End Page

1626

Location

England

Related Subject Headings

  • Vehicle Emissions
  • Public Health
  • North Carolina
  • Humans
  • Environmental Exposure
  • Electronic Health Records
  • Child
  • Asthma
  • Air Pollution
  • Air Pollutants