NEHA January/February 2025 Journal of Environmental Health

ADVANCEMENT OF THE SCIENCE

FIGURE 1

Hazard Ratios and 95% Confidence Intervals for Potential Effect Modifiers on the Relationship Between 10-Unit Increases of PM 2.5 and Asthma Exacerbations on Lag2

Sex Female Male Race and Ethnicity Native American

p = .56

Asian Black Hispanic White Age 0 – 4 5 – 17

p = .58

18 – 34 35 – 64 ≥ 65

p = .41

County

Ashland Forest Dodge

p = .16

Grant Sauk Vilas Taylor

Season

Winter Spring Summer Fall

p = .55

5.0

0.2

1.0 Hazard Ratio

were not available for the selected rural counties. Furthermore, we lacked informa- tion on individual-level covariates, such as smoking status and comorbidities, which could modify the relationship between PM 2.5 and asthma exacerbations. Conclusion Our study provides valuable insight into the characteristics of asthma exacerbations in rural areas. It also highlights the importance of looking beyond urban centers with the

highest levels of PM 2.5 when developing inter- ventions and policies to prevent asthma exac- erbations. Our findings support the need for eorts to improve a) air quality in rural areas to reduce the burden of asthma exacerbations in these communities and b) communications within rural areas regarding air quality and associations with poor asthma outcomes. Fur- ther research is needed to confirm our results in other rural areas and to identify individual- level risk factors that could modify the relation- ship between PM 2.5 and asthma exacerbations.

The implications of this research are impor- tant, and our findings could enhance targeted interventions in rural areas to improve asthma management and reduce poor outcomes asso- ciated with air pollution. Corresponding Author: Megan Elderbrook, MPH, CHES, Research Scientist–Epidemiolo- gist, Wisconsin Asthma Program, Wisconsin Department of Health Services, 1 West Wil- son, Room 150, Madison, WI 53703. Email: megan.elderbrook@wi.gov

Volume 87 • Number 6