Abstract
Background
Childhood asthma disproportionately affects Hispanic children in the United States. Nevertheless, few longitudinal cohorts exist in Gulf Coast communities where environmental exposures may compound sociodemographic vulnerabilities. Corpus Christi, a majority-Hispanic city with high levels of petrochemical industrial operations, reports higher asthma prevalence than state and national averages. BREATHE-CC (Bridging Respiratory Exposures, Asthma, and Environmental Health in Corpus Christi) is a prospective cohort designed to investigate the role of air pollutants, household conditions, and social determinants of health in asthma exacerbations and wheezing phenotypes.Methods
Approximately 200 children less than 10 years of age with asthma will be enrolled from Driscoll Children's Hospital. Enrolled participants complete baseline assessments and are followed monthly for up to 18 months using a parent-reported modified ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire that captures household exposures, asthma exacerbations, and wheezing episodes. Questionnaire responses will be validated and supplemented with electronic health record (EHR) reviews. Daily air pollutant concentrations (PM2.5, PM10, O3, SO2) from the Texas Commission on Environmental Quality (TCEQ) and U.S. Environmental Protection Agency (EPA) monitoring stations will be linked to participants' addresses. Generalized Additive Models (GAMs) and Poisson regressions will assess the associations between air pollutant exposures, household risk factors, asthma exacerbations, and wheezing phenotypes, adjusting for age, sex, body mass index (BMI), and other sociodemographic indicators. Group-Based Trajectory Modeling (GBTM) will identify latent phenotypes of wheezing.Discussion
This is a longitudinal cohort examining Hispanic children residing in the Gulf Coast petrochemical corridor. In particular, the study integrates granular geospatial environmental monitoring to link daily air pollutant exposure levels with asthma exacerbation risk. GBTM will also be used to identify latent wheezing phenotypes, especially focusing on differences between infectious and non-infectious wheezing. Recruitment will occur at a single hospital in the Coastal Bend region with a modest sample size, which may limit generalizability.Registration
Clinical trial number: not applicable. Open Science Framework [ https://osf.io/tbg6y/overview?view_only=87309518c35b4d78a7bbe79d5fa70ceb ].