BACKGROUND

Air pollution, particularly fine particulate matter (PM_2.5), has been consistently linked to respiratory morbidity, including asthma exacerbations. However, few studies have examined these relationships using statewide zip code–level panels with within-zip identification at a granular zip code level over time.

OBJECTIVE

To assess the association between short-term PM_2.5 exposure and the odds of any pediatric asthma admission from 2006 to 2021 across zip codes, with the goal of identifying patterns of environmental risk for asthma exacerbations.

METHODS

We analyzed zip code–level (zip-day) data from 2006 to 2021, combining hospitalization records for asthma admissions with environmental measures of conventional short-term PM_2.5 exposures, moving averages MA(0–1) and MA(0–3). Zip fixed-effects logistic regression was used to estimate the association between PM_2.5 exposure and the odds of asthma admission, adjusting for day of week, season, flexible calendar time within year, and meteorology (temperature and vapor pressure).

RESULTS

Higher short-term PM_2.5 was associated with higher odds of asthma admission at the zip-day level. Specifically, each +10 μg/m³ increase corresponded to approximately 4% to 5% higher odds (odds ratio ≈ 1.045; 95% CI 1.006–1.085). This relationship was observed under standard moving-average windows after adjustment for meteorological and temporal factors.

CONCLUSIONS

Acute increases in PM_2.5 are associated with a statistically detectable increase in asthma admission odds at the zip code level. Targeted strategies at the zip code level that respond to short-term air quality fluctuations may help reduce asthma-related health burdens.

POLICY IMPLICATIONS

These findings highlight the urgent need for public health interventions and environmental regulations that address short-term increases in air pollution, not just annual averages. Local and state-level policies aimed at monitoring, forecasting, and rapidly mitigating PM_2.5 surges could play a critical role in preventing asthma exacerbations, particularly in urban and vulnerable communities.

https://publications.aap.org/pediatricsopenscience/article/1/4/1/205275/Tiny-Particles-Big-Problems-PM2-5-Exposure-on?autologincheck=redirected