The following is a summary of “Living in environmental justice areas worsens asthma severity and control: Differential interactions with disease duration, age at onset, and pollution,” published in the November 2023 issue of Allergy & Immunology by Byrwa-Hill, et al.

Impoverished and historically marginalized communities often inhabit regions with elevated air pollution levels. For a study, researchers sought to assess the relationship between environmental justice (EJ) tract designation and asthma severity and control, focusing on the modifying impact of traffic-related air pollution (TRAP).

A retrospective analysis involved 1,526 adults with asthma in Allegheny County, Pennsylvania, enrolled in an asthma registry from 2007 to 2020. Asthma severity and control were determined based on global guidelines. EJ tract designation relied on residency in census tracts with ≥30% non-White and/or ≥20% impoverished populations. Each census tract’s TRAP exposures (NO₂ and black carbon) were categorized into pollution quartiles. Generalized linear model analyses were employed to assess the influence of the EJ tract and TRAP on asthma.

Individuals residing in an EJ tract were more frequently exposed to TRAP in the highest quartile range (66.4% vs 20.8%, P < .05). Living in an EJ tract elevated the odds of severe asthma, particularly in cases of later onset asthma. The odds of uncontrolled asthma increased with disease duration for all patients in EJ tracts (P < .05). Additionally, living in the highest quartile of NO₂ heightened the odds of uncontrolled asthma in individuals with severe disease (P < .05), while no significant impact of TRAP on uncontrolled asthma was observed in those with less severe disease (P > .05).

Residing in an EJ tract amplified the likelihood of severe and uncontrolled asthma, influenced by factors such as age at onset, disease duration, and potential TRAP exposure. The study underscored the imperative to understand the intricate environmental interactions affecting respiratory health in socially and economically marginalized groups.

Source: jacionline.org/article/S0091-6749(23)00565-1/fulltext