NEHA April 2023 Journal of Environmental Health

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associated with a reduction in weekly minutes of MVPA in a cohort of adolescents in Beijing, China (Yu et al., 2017), while a study among African American and Dominican children living in New York City found that those who engaged in >60 min of MVPA each day had higher personal exposure to black carbon, a pollutant associated with PM 2.5 (Lovinsky- Desir et al., 2016). Furthermore, a study con- ducted in California noted a positive associa- tion between wheezing and increased levels of NO 2 pollutants (Peters et al., 1999). Positive correlations between O 3 and phys- ical activity were no longer significant once we controlled for humidity and tempera- ture, indicating that the O 3 levels might not directly impact physical activity but rather that the weather conditions that are usually correlated with O 3 levels can impact physical activity—as O 3 peaks at high temperature as a result of the ambient NO 2 -O 3 photochemical reactions. The use of maximum 8-hr mean values of O 3 , however, did yield a significant association. Another study that considered O 3 exposure showed that a high daytime O 3 con- centration was consistent with an increased likelihood of new onset of asthma or exacer- bation of undiagnosed asthma in physically active children (McConnell et al., 2002). This finding could mean that the eects of O 3 levels might be more significant if the values reach a specific threshold. Comparison With Other Studies We noticed dierences in gender in physical activity rates that are consistent with other published values (Troiano et al., 2008) but not with BMI. In our study, children who were overweight and obesity were more physically active than children who were categorized as healthy weight or underweight. We found cor- relations between health insurance and physi- cal activity that could be related to asthma severity and more frequent visits in the Med- icaid setting when compared with those in the private setting. A study among children ages 3 to 17 years with asthma showed that those enrolled in Medicaid were more likely to have a preventive care visit during the last year, and approximately one half of them did receive advice from a clinician about physical activity (Perry & Kenney, 2007). Having a father or a sibling with asthma (but not a mother) was significantly cor- related with more time spent in sedentary

Participant-Specific Factors Compared With Physical Activity Levels TABLE 3 continued from page 19

Specific Factor

Participant Frequency ( N = 12)

Moderate to Vigorous Physical Activity

Sedentary Physical Activity

# (%) 8 (67)

p -Value

Allergic phenotype (aeroallergens)

63.1

.597

26.7

.794

4 (33) 3 (25) 9 (75)

64.1 61.8 64.1

26.0 27.4 26.1

Allergic phenotype (food)

.143

.366

Caretaker education ≤High school

6 (50) 6 (50)

63.8 63.1

.997

26.3 26.6

.771

≥High school

Health insurance coverage ( n = 11) Medicaid

.003

.039

6 (55) 5 (45) 2 (17)

66.5 61.2 59.9

23.9 27.9 29.9

Private

.013

.010

Smoking (outside of household)

10 (83)

64.2

25.7

Cooking Fuel Electric

.035

1 (8)

68.7 62.9

22.7 26.8

.127

Gas

11 (92)

Medications Leukotriene blockers

<.001

7 (58) 5 (42) 7 (58) 5 (42) 6 (50) 6 (50) 2 (17)

66.4 59.4 62.8 64.4 63.2 63.6 68.1 62.6 66.8 61.7 64.6 63.2

23.7 30.3 27.3 25.2 26.1 26.8 22.0 27.2 23.4 28.0 25.3 26.7

Short-acting bronchodilators

.155

.065

Inhaled corticosteroids

.894

.493

.012

.013

Long-acting bronchodilators and inhaled corticosteroids

10 (83)

.003

.007

Nasal corticosteroids

4 (33) 8 (67) 2 (17)

Systemic corticosteroids

.641

.791

10 (83)

Note. The p -value for the mean difference in physical activity between participants was calculated using the Kruskal– Wallis test. Bolded p -values are statistically significant. BMI = body mass index.

behavior and less time spent in MVPA. This finding is somewhat consistent with a study in Canada that found having a parent with asthma increased the odds of asthma and wheezing outcomes (Barry et al., 2014). This same study found increased odds of symptom

severity if a mother was a previous smoker, but the study did not report any data on hav- ing either a father or a sibling with asthma. It is possible that a father’s or sibling’s physical activity level has more influence on a child’s physical activity level (compared with the

Volume 85 • Number 8