Desert dust storm, ambient temperature, and pulmonary function among children with asthma in the Eastern Mediterranean

Background Climate change has contributed to increased dust events and rising ambient temperature, posing potential health risk for susceptible populations including children with asthma. The study aims to examine associations between exposure to desert dust storm (DDS) and higher ambient temperature with pulmonary function indicators, including forced expiratory volume in 1s (FEV 1 ), forced vital capacity (FVC) and FEV 1 /FVC% among asthmatic children during the dust season in the Eastern Mediterranean. Methods We conducted exploratory secondary analyses of repeated pulmonary function measurements from schoolchildren with asthma in Cyprus and Crete, Greece during spring of 2019 and 2021. Dust exposure was defined using short-term (at least one DDS day on the assessment day or during the preceding 7 days) and cumulative days (over the spring season) metrics based on site-specific DDS classifications as well as ambient temperature assessed from the nearest meteorological station. Associations were examined using linear mixed-effect models. Results Among the 135 children included, short-term DDS exposure was associated with a non-significant decrement in FEV 1 (-20.46 mL, 95% CI: -50.38, 9.46) and FVC (-27.21 mL, 95% CI: -59.45, 5.02). Cumulative dust exposure was associated with -3.52 mL (95% CI: -5.90, -1.14) difference in FEV 1 per DDS day. Ambient temperature averaged over 0-7 days before assessment was inversely associated with FEV 1 (-19.77 mL; 95% CI: -37.91, -1.63 per 5°C increase) and FEV 1 /FVC% (-0.81; 95% CI: -1.36, -0.25 per 5 °C increase), with no statistical evidence of effect modification by short-term DDS exposure. Conclusions This exploratory secondary analysis demonstrated inverse associations of cumulative DDS exposure and ambient temperature with pulmonary function among children with asthma, while short-term DDS associations were not statistically significant. These findings may inform the management of children with asthma during desert dust seasons, but confirmation in larger studies is required.