When University of Washington researchers discovered high rates of air pollution and childhood asthma in communities near Sea Tac International Airport, the next step became urgently clear — how to help.
Building on Public Health Seattle & King County’s evidence-based community health worker program that serves people with uncontrolled asthma, UW researchers wanted to know what additional strategies might prevent asthma attacks that lead to emergency room visits or school absences.
This question is at the heart of a new study called the Airport, Air quality and Asthma (AAA) Project, led by Assistant Professor Elena Austin with the Department of Environmental & Occupational Health Sciences.
“This study emerged as a direct follow-up to an air pollution study we conducted that identified impacts of transportation sources including cars, trucks and aircraft on communities near the airport,” Austin said. “We know that exposure to air pollution increases both the risk and severity of asthma in children.”
Funding from state legislature
To support children with asthma and learn how to better help children living near airports, the state legislature included research funding in the 2021 Washington Climate Commitment Act, which funds this study.
The AAA study focuses on families that live within a 10-mile radius of the airport and has three components:
- Expansion of an asthma education program delivered by Public Health – Seattle & King County’s Community Health Worker program.
- Placement and evaluation of air cleaners in the bedrooms of children with asthma. Participants are randomly assigned to receive an air cleaner with a high-efficiency particulate air (HEPA) filter or a less effective filter.
- Mapping the impacts of asthma, including ER visits, to identify the most vulnerable communities and asthma hotspots.
Caregivers report symptoms
Researchers have so far enrolled 28 child-caregiver pairs. The caregivers complete weekly surveys over a three-month period to report on the children’s asthma symptoms and flare-ups.
The research team installed air monitors in children’s bedrooms to measure temperature, relative humidity and indoor fine air particles known as PM2.5. A data logger tracks when the air cleaner is used, and which setting is selected.
Among the children enrolled in the study, all take at least one medication and half have a steroid prescription for asthma. Roughly 40 percent have been to the ER at least once with an asthma attack.
Impact on marginalized communities
Earlier DEOHS research found that communities around airports suffer short- and long-term health effects related to air pollution. This includes worsened asthma, chronic disease and early death. Marginalized communities and people of color are often hit the hardest.
Pamela Lim, who is enrolled in the concurrent degree program for a Master of Urban Planning and Master of Public Health, signed on as a research assistant for the project because studying these health disparities was especially meaningful to her.
“People who live near the airport are people who, on average, are less wealthy, they’re people of color, they have more health risks and other exposures,” she said. “I was interested in supporting research that would address the problem or alleviate the problem.”
Community organization outreach
Community engagement is an especially valuable part of the AAA study. Study partners include African Community Housing & Development, Lutheran Community Services Northwest and Villa Comunitaria. The community health workers at Public Health Seattle & King County are from and represent the diverse population that live near the airport.
“It is so exciting to work on a project that engages communities, public health, researchers and policy makers to develop effective mitigations for families,” Austin said.
Lim said she plans to interview the community health workers as part of her master’s thesis project.
“I’m interested in talking to the community health workers to learn more about bridging that gap between research and the people served. I’m interested to see how that interaction plays out in the real world, not in a classroom,” she said.
Lim is hopeful the AAA model of community engagement could prove successful for other public health outreach projects beyond asthma.
Jan Capps, manager for PHSKC’s Asthma and Community Health Worker Program, said, “This research will not only help us better serve children with asthma living near airports, but also contribute to the knowledge base of air pollution and indoor air quality that has multiple impacts on health.”
