Long-term ambient temperature and asthma severity and hospitalization in children: a population-based study

To estimate the risk projection of temperature on pediatric asthma severity and hospitalization under four Shared Socioeconomic Pathways (SSPs) possible future climate scenarios using the Intergovernmental Panel on Climate Change (IPCC) model. A retrospective study was conducted involving 102,160 pediatric asthma patients from the Taipei Medical University Clinical Research Database (TMUCRD). We utilized global climate model (GCM) outputs to project future temperature for each subject from optimistic (SSP126) to pessimistic (SSP585) projections. A multinomial logistic regression was used to examine the odds ratio of pediatric asthma severity and hospitalization. A 1 °C increase in 1-year, 5-year, and 10-year average temperatures was associated with 1.004-fold (95% CI: 1.003-1.005) and 1.332-fold (95% CI: 1.327-1.338), 1.004-fold (95% CI: 1.002-1.005) and 1.303-fold (95% CI: 1.298-1.308), and 1.005-fold (95% CI: 1.004-1.006) and 1.282-fold (95% CI: 1.278-1.287) increase in the OR for mild persistent and hospitalization of pediatric asthma. We observed a non-linear association between temperature under SSP126, SSP245, SSP370 and SSP585 with moderate persistent pediatric asthma and pediatric asthma hospitalization, with the highest OR increases observed in 2033 at 33.4% and 32.3%, 27.6% and 32.3%, 29.1% and 32.4%, and 27.2% and 32.3%, respectively. Conclusion: Projected future temperature changes as a result of climate change may be associated with a possible increase in pediatric asthma severity and hospitalization in the coming years, with an expected increase of 8.0% and 2.5% per 1 °C increase, respectively. Pediatric asthma patients may be more susceptible to poorer outcomes under climate change in the future. What is Known: • Rising temperatures have been linked to increased asthma severity and hospitalization. • Climate change worsening pediatric asthma outcomes and increasing the healthcare burden. What is New: • Long-term exposure to rising ambient temperatures and PM_2.5 is significantly associated with increased odds of moderate and severe persistent asthma in children. • Theoretical projections linking multiple climate model scenarios (SSP126-SSP585) with future pediatric asthma burden.