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. 2023 Jan-Dec:14:21501319231173813.
doi: 10.1177/21501319231173813.

Paired Indoor and Outdoor Nitrogen Dioxide Associated With Childhood Asthma Outcomes in a Mixed Rural-Urban Setting: A Feasibility Study

Chung-Il Wi  1 , Janneane F Gent  2 , Joshua T Bublitz  1 , Katherine S King  1 , Euijung Ryu  1 , Keli Sorrentino  2 , Julie Plano  2 , Lisa McKay  2 , Julie Porcher  1 , Philip H Wheeler  1 , Sergio E Chiarella  1 , Andrew T DeWan  2 , Krystal J Godri Pollitt  2   3 , Beverley J Sheares  4 , Brian Leaderer  2 , Young J Juhn  1
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Paired Indoor and Outdoor Nitrogen Dioxide Associated With Childhood Asthma Outcomes in a Mixed Rural-Urban Setting: A Feasibility Study

Chung-Il Wi et al. J Prim Care Community Health. 2023 Jan-Dec.

Abstract

Introduction: Nitrogen dioxide (NO2) is known to be a trigger for asthma exacerbation. However, little is known about the role of seasonal variation in indoor and outdoor NO2 levels in childhood asthma in a mixed rural-urban setting of North America.

Methods: This prospective cohort study, as a feasibility study, included 62 families with children (5-17 years) that had diagnosed persistent asthma residing in Olmsted County, Minnesota. Indoor and outdoor NO2 concentrations were measured using passive air samples over 2 weeks in winter and 2 weeks in summer. We assessed seasonal variation in NO2 levels in urban and rural residential areas and the association with asthma control status collected from participants' asthma diaries during the study period.

Results: Outdoor NO2 levels were lower (median: 2.4 parts per billion (ppb) in summer, 3.9 ppb in winter) than the Environmental Protection Agency (EPA) annual standard (53 ppb). In winter, a higher level of outdoor NO2 was significantly associated with urban residential living area (P = .014) and lower socioeconomic status (SES) (P = .027). For both seasons, indoor NO2 was significantly higher (P < .05) in rural versus urban areas and in homes with gas versus electric stoves (P < .05). Asthma control status was not associated with level of indoor or outdoor NO2 in this cohort.

Conclusions: NO2 levels were low in this mixed rural-urban community and not associated with asthma control status in this small feasibility study. Further research with a larger sample size is warranted for defining a lower threshold of NO2 concentration with health effect on asthma in mixed rural-urban settings.

Keywords: NO2; air quality; gas stove; rural; socioeconomic status; urban.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Photograph of an NO2 monitor (Palmes tube) clipped to blue plastic weather protector jar and suspended from a tree branch in the backyard of a home. Unexposed end of the Palmes tube within the protector jar is sealed (green cap with white sample label), and screen lid is replaced and screwed on tightly.
Figure 2.
Figure 2.
Spatial distribution of residences classified by levels of observed outdoor NO2 in winter, and average annual daily traffic (AADT) on numbered roadways, Olmsted County, MN.
See this image and copyright information in PMC

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