Clean Air Asthma Surveillance
J.Y.
1Drexel
Background
Clean Air Council (CAC) was founded in 1967 by a group of
policy makers, physicians, businesses, and community
organizing leaders and has served to address environmental
issues that threaten the health of the communities around
them. The Council works to inform and educate the public
concerning the health, economic, and aesthetic effects of air
pollution and technological and legal tools available for its
control. Headquartered in Philadelphia, the Council expanded
its mission of protecting everyone’s right to breathe clean air
into other environmental issues, such as neighborhood toxics,
indoor air pollution and children’s environmental health.
Due to air quality issues and triggers by pollutants and
particulate matter from the interstate highways and the ports
of Philadelphia, asthma has been one of the issues that the
Council seeks to address in its advocating of children’s health.
Although the Council works to improve asthma awareness
education to the community and to health providers through a
variety of asthma education fairs, there has not been a firm
grasp as to the extent of the asthma problem within the
surrounding community. Clean Air Council has never
undertaken any type of studies on children and asthma health
on the community it serves.
A brief surveillance survey was created based on the Brief
Pediatric Asthma Screen (BPAS+) and distributed in
Southeastern Philadelphia in the 19148 zip-code in order to
better assess the asthma’s affect on the community and to
gain knowledge on how to better serve and allocate resources
to education and prevention and control of asthma in the
community.
Project Aim/Goal
Asthma is caused by a variety of triggers such as
environmental pollutants, dust, allergens, particulate matter
from ports running diesel powered machinery and high dense
traffic areas like the interstate highways.
It is assumed that poor air quality and particulate matter from
the ports and the interstate highways that borders zipcode
19148, may contribute to the overall rates of asthma within
Philadelphia.
Through this practicum project, Clean Air Council hopes to
obtain information on a brief overview of asthma statistics and
prevalence in the 19148 zip-code. Based on collected
surveillance statistics, Clean Air Council will be better able to
focus their resources and education and children’s health
avocation, as well as serve the community needs towards
children and asthma health.
1
Lee ,
S.
2
McCormick ,
J.O.
2
Minott
University School of Public Health 2Clean Air Council
.
Methods
 A survey based on the Brief Pediatric Asthma Screen
(BPAS+) was created consisting of 8 Yes/No questions
without any identifying markers
 South Philadelphia zip-code 19148 was broken down into 20
numbered grids, focusing only on residential areas
 Each grid was randomly selected by random number
generator and surveys administered in each randomly
selected block
 Surveys were administered in each block for a slotted time of
1.5 hrs per gridded block
 Survey data was analyzed with SPSS for descriptive
statistics for asthma case prevalence, possible undiagnosed
cases, and cross tabulations
Results
 There was a total of 386 household surveys collected
--1152 individuals in the sample population
 Asthma prevalence in 19148 is 14.7%
 Collection of surveys was done by Clean Air Staff through
door to door surveying
 Possible undiagnosed cases in 19148 is 8.42%, which may
have some association to the surrounding port and interstate
highway
 Surveying response bias was masked by stating it as an air
quality survey
Descriptive Statistics
 Surveys were analyzed using brief descriptive statistics to
measure prevalence of current asthma diagnoses and
possible undiagnosed cases
 Possible undiagnosed cases were marked as showing
symptoms of asthma based on the 8 yes/no questions
--preexisting conditions were accounted for (eg. Chronic
Bronchitis, Emphysema, etc)
 Each positive asthma case was plotted onto a map to provide
visual of the sample prevalence of zip-code for CAC.
Sample of asthma survey utilized by Clean Air Council
N
.
Asthma Cases
No. Stayed home w/ Breathing Issues
Episodes of Wheezing
Visit Hospital/ER for Breathing Issues
Possible Undiagnosed Cases
Total Sample Pop.
170
132
141
92
97
(%)
(14.7)
(11.5)
(12.2)
(7.98)
(8.42)
1152
 Among asthma cases 98 individuals are smokers or are
exposed to second hand smoke
 Among asthma cases 72 individuals are not exposed to
tobacco smoke
Cross tabulation
Smoker * Asthma Diagnoses
Smoker Status
NO
YES
Total
Asthma Status
NO
YES
154
72
109
98
263
170
Discussion
In this brief surveillance study of asthma prevalence it has been
shown that asthma rate in zip-code 19148 is roughly 14.7%,
and possible undiagnosed cases are at an estimated 8%, which
is comparable to national asthma rates. This brief study also
indicates that Clean Air should continue in their advocacy of
asthma awareness and education.
Although this surveillance study does not prove causation, it
does give a general assessment as to the extent of asthma
rates in South Philadelphia. In addition, with these brief
prevalence statistics Clean Air Council can better assess
whether asthma in South Philadelphia, and gives perspective
on where to allocate further resources to outreach and
education.
Within this brief prevalence study there were many limitations
and concerns. One limitation that this project ran into early on
was the time frame into which to conduct surveying in the
neighborhoods, in which would contribute to non-response bias
of many households and will skew population demographics
such as children. In addition, being a basic prevalence and
asthma surveillance this study does not indicate or prove
causation.
An improvement and possible future research on the
assessment of asthma in zip-code 19148 would be to conduct a
epidemiological study by comparing subjects from zip-code
19148 with another zip-code on asthma cases.
Acknowledgements
Dr. Steven Lankenau – Practicum Facilitator
Joseph Minott, Esq. – CAC Exec. Dir., Site Preceptor
Clean Air Council Staff