Models for Forecasting Asthma Exacerbations in Urban Environments

Materials associated with the Analytic Solutions for Real-Time Biosurveillance: Models for Forecasting Asthma Exacerbations in Urban Environments consultancy held March 30-31, 2016 at the Boston Public Health Commission (BPHC).

Problem Summary

Asthma exacerbation can be triggered by a number of environmental factors and respiratory viral infections.  Asthma control plans are essential in preventing exacerbation.  An early warning of increased atmospheric/environmental risk would enable public health agencies to alert asthmatic patients and providers. These alerts would also include prevention messaging and allow asthmatics to ensure that their plans are up to date.  BPHC seeks analytic methods for forecasting conditions that are associated with asthma exacerbations.  The forecast should consider the impact of respiratory infections (rhinovirus, influenza), temperature extremes, anomalous air quality measurements, and pollen.  Available data sources are emergency department visit records, weather data, air quality data, and pollen counts.

Attachments

• Use case summary
• Consultancy agenda
• List of attendees
• Final report

Weather Data Sources from NOAA

Air Quality: http://airquality.weather.gov/

Dust, ozone, and smoke: ftp://tgftp.nws.noaa.gov/SL.us008001/ST.opnl/DF.gr2/DC.ndgd/GT.aq

PM2.5: http://para.nomads.ncep.noaa.gov/pub/data/nccf/com/aqm/para/ 

GRIB2 tools: http://www.nco.ncep.noaa.gov/pmb/docs/grib2/ 

BUFKIT software to decode/display BUFR station data: http://wdtb.noaa.gov/tools/BUFKIT/ 

Long-term archive: http://nomads.ncdc.noaa.gov/index.php 

NAM predictions for the past year: ftp://nomads.ncdc.noaa.gov/NAM/Grid218/

References

Morbidity and Mortality Weekly Reports (MMWR) publications on asthma 

Respiratory virus transmission dynamics determine timing of asthma exacerbation peak: Evidence from a population-level model. 

Eggo RM, Scott JG, Galvani AP, and Meyers LA. 2016. Respiratory virus transmission dynamics determine timing of asthma exacerbation peak: Evidence from a population-level model. PNAS, 113(8): 2194-9.  

The Relationship of Fall School Opening and Emergency Department Asthma Visits in a Large Metropolitan Area.

 Silverman RA, Kazuhiko I, Stevenson L, and Hastings HM. 2005. The Relationship of Fall School Opening and Emergency Department Asthma Visits in a Large Metropolitan Area. Arch Pediatr Adolesc Med, 159(9): 818-823.

The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002 - 2012.

 Kazuhiko I, Weinberger KR, Robinson GS, Sheffield PE, Lall R, Mathes R, Ross Z, Kinney PL, and Matte TD. 2015. The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002 - 2012. Environmental Health, 14: 71. 

Pediatric patient asthma-related emergency department visits and admissions in Washington, DC, from 2001-2004, and associations with air-quality, socio-economic status and age group.

Babin SM, Burkom HS, Holtry RS, Tabernero NR, Stokes LD, Davies-Cole JO, DeHaan K, and Lee DH. 2007. Pediatric patient asthma-related emergency department visits and admissions in Washington, DC, from 2001-2004, and associations with air-quality, socio-economic status and age group. Environmental Health, 6:9.

Medicaid patient asthma-related acute care visits and their associations with ozone and particulates in Washington, DC, from 1994-2005. 

Babin S, Burkom H, Holtry R, Tabernero N, Davies-Cole J, Stokes L, DeHaan K, and Lee D. Int J Environ Health Res, 18(3): 209-21. 

Does outdoor air pollution induce new cases of asthma? Biological plausibility and evidence; a review.

Gowers AM, Cullinan P, Ayres JG, Anderson HR, Strachan DP, Holgate ST, Mills I, Maynard RL. 2012. Respirology, 17(6): 887-98.

What do we know about asthma triggers? a review of the literature. 

Vernon MK, Wiklund I, Bell JA, Dale P, Chapman AR. 2012. What do we know about asthma triggers? a review of the literature. J Asthma, 49(10): 991-8. 

Using community level strategies to reduce asthma attacks triggered by outdoor air pollution: a case crossover analysis. 

Raun LH, Ensor KB, Persse D. 2014. Using community level strategies to reduce asthma attacks triggered by outdoor air pollution: a case crossover analysis. Environmental Health, 13:58.