AIRWEIGHS: A randomized controlled trial of air cleaners in normal weight and overweight/obese children with asthma.

Background: Overweight and obesity is a risk factor for increased asthma morbidity among children, and overweight/obese children with asthma may be more susceptible to air pollution.

Objective: To test the hypothesis that there would be greater improvement in asthma from an air cleaner intervention to reduce indoor air pollution among overweight/obese children compared to normal weight children.

Methods: AIRWEIGHS is a randomized, placebo-controlled air cleaner trial designed to reduce indoor air pollution and test the differential health impact among overweight/obese children versus normal weight children with asthma.

Moving to lower-poverty neighborhoods offers broad benefits for children with asthma, regardless of sex or other baseline characteristics.

Background: It was previously found that moving to lower-poverty/higher-opportunity neighborhoods as part of a housing mobility program was associated with improvements in asthma exacerbations and symptoms among children with asthma. Whether some subsets of children with asthma experience a greater improvement in asthma morbidity after moving is unknown.

Objective: Our aim was to determine whether the benefits of moving to lower-poverty/higher-opportunity neighborhoods were concentrated in subsets of participants with asthma.

Alignment of Air Pollution Exposure Inequality Metrics with Environmental Justice and Equity Goals in the United States.

A growing literature within the field of air pollution exposure assessment addresses the issue of environmental justice. Leveraging the increasing availability of exposure datasets with broad spatial coverage and high spatial resolution, a number of works have assessed inequalities in exposure across racial/ethnic and other socioeconomic groupings. However, environmental justice research presents the additional need to evaluate exposure inequity-inequality that is systematic, unfair, and avoidable-which may be framed in several ways.

A causal machine-learning framework for studying policy impact on air pollution: a case study in COVID-19 lockdowns.

When studying the impact of policy interventions or natural experiments on air pollution, such as new environmental policies or the opening or closing of an industrial facility, careful statistical analysis is needed to separate causal changes from other confounding factors. Using COVID-19 lockdowns as a case study, we present a comprehensive framework for estimating and validating causal changes from such perturbations. We propose using flexible machine learning-based comparative interrupted time series (CITS) models for estimating such a causal effect.

A DYNAMIC SPATIAL FILTERING APPROACH TO MITIGATE UNDERESTIMATION BIAS IN FIELD CALIBRATED LOW-COST SENSOR AIR POLLUTION DATA.

Low-cost air pollution sensors, offering hyper-local characterization of pollutant concentrations, are becoming increasingly prevalent in environmental and public health research. However, low-cost air pollution data can be noisy, biased by environmental conditions, and usually need to be field-calibrated by collocating low-cost sensors with reference-grade instruments. We show, theoretically and empirically, that the common procedure of regression-based calibration using collocated data systematically underestimates high air pollution concentrations, which are critical to diagnose from a health perspective.

Association of a Housing Mobility Program With Childhood Asthma Symptoms and Exacerbations.

Importance: Structural racism has been implicated in the disproportionally high asthma morbidity experienced by children living in disadvantaged, urban neighborhoods. Current approaches designed to reduce asthma triggers have modest impact.

Objective: To examine whether participation in a housing mobility program that provided housing vouchers and assistance moving to low-poverty neighborhoods was associated with reduced asthma morbidity among children and to explore potential mediating factors.

Principal stratification analysis to determine health benefit of indoor air pollution reduction in a randomized environmental intervention in COPD: Results from the CLEAN AIR study.

Background: Indoor air quality represents a modifiable exposure to Chronic Obstructive Pulmonary Disease (COPD) health. In a randomized controlled trial (CLEAN AIR study), air cleaner assignment had causal effect in improving COPD outcomes. It is unclear, however, what is the treatment effect among those for whom intervention reduced air pollution and whether it was reduction in fine particulate matter (PM) or nitrogen dioxide (NO) that contributed to such improvement.

Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods.

Background: Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood.

Indoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease.

Indoor air pollution represents a modifiable risk factor for respiratory morbidity in chronic obstructive pulmonary disease (COPD). The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. To determine the association between indoor particulate matter (PM) and heart rate variability (HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV.

Comprehensive home environmental intervention did not reduce allergen concentrations or controller medication requirements among children in Baltimore.

Objective: To determine if the addition of home environmental control strategies (ECSs) to controller medication titration reduces asthma controller medication requirements and in-home allergen concentrations among children with persistent asthma in Baltimore City.

Methods: 155 children ages 5-17 with allergen-sensitized asthma were enrolled in a 6-month randomized clinical trial of multifaceted, individually-tailored ECS plus asthma controller medication titration compared to controller medication titration alone. Participants had to meet criteria for persistent asthma and have had an exacerbation in the previous 18 months.

Risk factors for antimicrobial resistance among Staphylococcus isolated from pets living with a patient diagnosed with methicillin-resistant Staphylococcus aureus infection.

It has been suggested that pets play a critical role in the maintenance of methicillin-resistant (MR) and multidrug-resistant (MDR) Staphylococcus spp. in the household. We examined risk factors for carriage of antimicrobial-resistant coagulase-positive staphylococci, with particular attention to Staphylococcus aureus and Staphylococcus pseudintermedius isolated from pets living in households of people diagnosed with methicillin-resistant S.

Phthalate biomarkers and associations with respiratory symptoms and healthcare utilization among low-income urban children with asthma.

Background: Phthalates are synthetic chemicals present in building materials, personal care products and other consumer goods. Limited studies link phthalates to pediatric asthma incidence; however, their effects on respiratory-related outcomes among those with pre-existing asthma remains unclear.

Objective: We examined associations between phthalates and asthma symptoms, healthcare use, lung function, and lung inflammation among children with asthma.

Ambient ozone effects on respiratory outcomes among smokers modified by neighborhood poverty: An analysis of SPIROMICS AIR.

Background: Neighborhood poverty has been associated with poor health outcomes. Previous studies have also identified adverse respiratory effects of long-term ambient ozone. Factors associated with neighborhood poverty may accentuate the adverse impact of ozone on respiratory health.

Assessing the health estimation capacity of air pollution exposure prediction models.

Background: The era of big data has enabled sophisticated models to predict air pollution concentrations over space and time. Historically these models have been evaluated using overall metrics that measure how close predictions are to monitoring data. However, overall methods are not designed to distinguish error at timescales most relevant for epidemiologic studies, such as day-to-day errors that impact studies of short-term health associations.

Estimating the health effects of environmental mixtures using principal stratification.

The control of ambient air quality in the United States has been a major public health success since the passing of the Clean Air Act, with particulate matter (PM) reductions resulting in an estimated 160 000 premature deaths prevented in 2010 alone. Currently, public policy is oriented around lowering the levels of individual pollutants and this focus has driven the nature of much epidemiological research. Recently, attention has been given to viewing air pollution as a complex mixture and to developing a multi-pollutant approach to controlling ambient concentrations.

Do temporal trends of associations between short-term exposure to fine particulate matter (PM) and risk of hospitalizations differ by sub-populations and urbanicity-a study of 968 U.S. counties and the Medicare population.

While associations between short-term exposure to fine particulate matter (PM) and risk of hospitalization are well documented and evidence suggests that such associations change over time, it is unclear whether these temporal changes exist in understudied less-urban areas or differ by sub-population. We analyzed daily time-series data of 968 continental U.S.

Neighborhoods, Caregiver Stress, and Children's Asthma Symptoms.

Background: Neighborhood and caregiver characteristics have each been linked to children's asthma outcomes, but less is known about how caregiver psychosocial functioning may explain the link between neighborhood characteristics and asthma outcomes.

Objective: To examine associations between neighborhood safety, caregiver stress and depressive symptoms, and children's asthma outcomes, and to evaluate whether caregiver stress and depressive symptoms mediate the relationship between neighborhood safety and asthma outcomes.

Methods: We analyzed baseline data from a prospective cohort study of the effects of a housing mobility program on children's asthma-related outcomes.

Indoor Environmental Factors May Modify the Response to Mouse Allergen Reduction Among Mouse-Sensitized and Exposed Children with Persistent Asthma.

Background: Whether concomitant home exposures modify the effectiveness of mouse allergen reduction among mouse-sensitized children with asthma is unknown.

Objective: To determine whether a lower baseline home mouse allergen level, lower particulate matter 10 μ or less (PM), and the absence of sensitization and exposure to other indoor allergens are associated with greater improvements in asthma associated with mouse allergen reduction.

Methods: A secondary analysis of a randomized clinical trial of a home mouse allergen intervention was performed to examine the effect of 3 indoor factors on the relationship between mouse allergen reduction and a range of asthma outcomes.

Randomized Clinical Trial of Air Cleaners to Improve Indoor Air Quality and Chronic Obstructive Pulmonary Disease Health: Results of the CLEAN AIR Study.

Indoor particulate matter is associated with worse chronic obstructive pulmonary disease (COPD) outcomes. It remains unknown whether reductions of indoor pollutants improve respiratory morbidity. To determine whether placement of active portable high-efficiency particulate air cleaners can improve respiratory morbidity in former smokers.