Abstract Rationale The U.S. Air Quality Index (US-AQI) is a tool designed to alert the public to poor outdoor air quality, thus allowing for behavioral action to reduce adverse outcomes via reduced exposure. Recent years have seen a surge in products that provide an AQI, most of which differ in methodology from the US-AQI reported on AirNow. If and what AQI products children with asthma use is under-explored. Methods An AQI questionnaire was administered to children participating in The Transcript/Omics for Precision Medicine in Asthma Study (TOPMAS), a 48-week observational study of nasal transcriptomic profiles and severe asthma exacerbations (SAE) in youth aged 6 to 21 years, recruited in 2023- 2025 from UPMC Children’s Hospital of Pittsburgh. All participants had physician-diagnosed asthma and at least one SAE in the previous year, and had been prescribed an inhaled corticosteroid. Wilcoxon rank sum or X2 was used for bivariate analyses. Results The mean age of the 112 participants was 12.5 years, and most (62%) had public insurance, were White (51%), and had ≥3 days/week of moderate or vigorous outdoor activity (62%). Most (75%) were aware of alerts or the AQI and 67% reported learning about or checking the AQI prior to going outdoors at least once in the past year. Of those checking the AQI, 72% reported making a change in outdoor activity based on air quality. A phone app was the most common source of information (75%) followed by TV, radio or social media (44%) and internet/website (24%), with fewer reporting County Alert Service (14%). The weather app was the most frequently reported source of information (83%), with only 6% reporting checking the US AirNow app (Figure 1). Regarding healthcare professional counseling, less than half reported discussion of outdoor air pollution as a trigger, and fewer reported discussion of activity reduction (38%). In bivariate analyses, asthma control test (ACT) or childhood-ACT and forced expiratory volume in 1sec/forced vital capacity was lower, and early-life tobacco exposure was greater in children reporting a provider discussion, suggesting poorly controlled asthma may impact discussion. Conclusions Most children with asthma endorse checking an AQI and nearly half report activity modification, yet few report discussion or recommendations from a healthcare provider. The weather app, which does not report values equivalent to AirNow (US-AQI), is the most frequently reported source of air quality information. Further research is needed to determine if use of the US-AQI improves asthma outcomes. This abstract is funded by: Breathe Pennsylvania, University of Pittsburgh/UPMC Precision Medicine Institute
Rosser et al. (Fri,) studied this question.
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