J Allergy Clin Immunol

Objective:To use spatial analysis methodology to analyze residential and school proximity to major roadways and pediatric asthma morbidity.Methods:The School Inner-City Asthma Study (n=350) recruited school-aged children with asthma. Each participant\u2019s school and home addresses were geocoded and distances from major roadways were measured to calculate a composite measurement accounting for both home and school traffic exposure. Generalized estimated equation models were clustered by subject and adjusted for age, race/ethnicity, gender, income, environmental tobacco smoke, controller medication, upper respiratory tract infections and seasonality.Results:The majority of participants (62%) attended schools within 100 meters from major roadways and 40% also resided within 100 meters of major roadways. In multivariate analyses, major roadway proximity was independently associated with increased asthma symptom days. Above a threshold of 100 meters, children had 29% less odds of a symptom day over the past 2 weeks for each 100 meter increase in distance from major roadway (OR 0.71; 95% CI:0.58\u20130.87; p <0.01). Children farther from a major roadway also had significantly less reported health care utilization (OR 0.63; 95% CI: 0.47\u20130.85; p<0.01); and significantly less likely to have poor asthma control (OR 0.80; 95% CI: 0.69\u20130.94; p< 0.01). There was not a meaningful association between distance to major roadway and lung function outcomes.Conclusions:Proximity to major roadway, a composite measurement of home and school exposure, primarily driven by home exposure, was associated with greater asthma morbidity. More studies are needed to evaluate the independent effect of school distance to roadway on asthma morbidity.U01 AI110397/AI/NIAID NIH HHS/United StatesK23 AI104780/AI/NIAID NIH HHS/United StatesU19 AR069525/AR/NIAMS NIH HHS/United StatesK23 ES023700/ES/NIEHS NIH HHS/United StatesK24 AI106822/AI/NIAID NIH HHS/United StatesR01 AI073964/AI/NIAID NIH HHS/United StatesP01 ES009825/ES/NIEHS NIH HHS/United StatesR01 HL137192/HL/NHLBI NIH HHS/United StatesP30 ES000002/ES/NIEHS NIH HHS/United StatesU61 TS000237/TS/ATSDR CDC HHS/United StatesK23 AI106945/AI/NIAID NIH HHS/United StatesL40 AI107923/AI/NIAID NIH HHS/United StatesR01 ES030100/ES/NIEHS NIH HHS/United StatesU10 HL098102/HL/NHLBI NIH HHS/United States2021-01-01T00:00:00Z31557500PMC69493668874vault:3440