Bozigar Matthew, Connolly Catherine L, Vermeer Kimberly, Carvalho Luis, Cohen Robyn T, Dugas Julianne N, Levy Jonathan I, Fabian Maria Patricia
Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA.
Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA; Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, 722 W 168th St, New York, NY 10032, USA.
Ann Epidemiol. 2025 May;105:47-52. doi: 10.1016/j.annepidem.2025.04.001. Epub 2025 Apr 4.
The effects of in-home environmental exposures (IHEEs) on asthma are challenging to examine in populations because information on asthma triggers is usually absent. We leveraged data from electronic health records (EHRs) to investigate the associations of residential cockroach and rodent exposures with lung function among children with asthma.
We merged clinical pulmonary function test data from EHRs for children with asthma from a large safety net hospital in the Northeast United States with publicly available geospatial data matched to patient addresses. Predicted presence of key IHEE asthma triggers, cockroaches and rodents, were included as main exposures and housing parcel features and census tract characteristics were included as potential confounders in a sensitivity analysis. We fit latent Bayesian hierarchical models of percent predicted forced expiratory volume in one second (FEV%).
The study population of 1070 children had a mean age of 10.2 years and 75 % identified as Black, many living in historically segregated neighborhoods. In models adjusted for individual characteristics, we observed 2.26 (95 % credible interval, 95 %CrI: - 3.72, - 0.79) and 2.58 (95 %CrI: - 4.54, - 0.66) percentage points (pp) lower FEV% from a one-unit increase in the log-odds of the probability of cockroach and rodent presence, respectively. The association with lung function increased in magnitude for cockroach exposure but attenuated for rodent exposure in sensitivity analyses.
IHEEs were associated with worse lung function among children with asthma in a safety net population. The observed associations underscore how injustices in housing and neighborhood characteristics contribute to asthma morbidity.
由于通常缺乏有关哮喘触发因素的信息，因此在人群中研究家庭环境暴露（IHEE）对哮喘的影响具有挑战性。我们利用电子健康记录（EHR）数据来调查哮喘儿童中住宅蟑螂和啮齿动物暴露与肺功能之间的关联。
我们将美国东北部一家大型安全网医院的哮喘儿童的EHR临床肺功能测试数据与公开可用的地理空间数据进行合并，这些地理空间数据与患者地址相匹配。预测的关键IHEE哮喘触发因素（蟑螂和啮齿动物）的存在作为主要暴露因素，而房屋地块特征和人口普查区特征作为敏感性分析中的潜在混杂因素。我们拟合了一秒钟用力呼气量（FEV%）预测百分比的潜在贝叶斯分层模型。
1070名儿童的研究人群平均年龄为10.2岁，75%被认定为黑人，许多人生活在历史上隔离的社区。在根据个体特征进行调整的模型中，我们观察到蟑螂和啮齿动物存在概率的对数优势每增加一个单位，FEV%分别降低2.26（95%可信区间，95%CrI：-3.72，-0.79）和2.58（95%CrI：-4.54，-0.66）个百分点（pp）。在敏感性分析中，与肺功能的关联在蟑螂暴露方面幅度增加，但在啮齿动物暴露方面减弱。
在安全网人群中，IHEE与哮喘儿童的肺功能较差有关。观察到的关联强调了住房和社区特征方面的不公正如何导致哮喘发病率上升。
