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Researchers used inhaler sensors to study frequency of asthma rescue medication usage and emergency room visits following changes in emissions from coal-fired power plants in Louisville, Kentucky. 28 JUNE 2020 Inhalation BACK PAGE The "AIR Louisville" collaboration "Coal- red power plants are known to emit pollutants associ- ated with adverse health e ects, including increased asthma at- tacks, asthma-related emergency department visits and hospital- izations. 1 "In the United States, Kentucky "has historically ranked among the top ve states for emis- sions due to power generation. 2 " "In addition, the city of Louis- ville has one of the highest rates of asthma in the US. 3 " In 2012, the "AIR Louisville" pub- lic/private collaboration launched a pilot program involving approx- imately 1,200 Louisville residents who had asthma or COPD. eir inhalers were equipped with dig- ital sensors (Propeller Health, Madison, WI, US) to capture data on medication use, symptoms and environmental factors and "gain insights into the impact of local air quality on the burden of respi- ratory disease in the community." Energy transitions provide research opportunity en, between 2013 and 2016, one coal- red power plant in the Louisville, Kentucky area retired coal as an energy source. During the same period, three additional plants installed stricter sulfur diox- ide (SO 2 ) emission controls, in order to comply with regulations from the United States Environ- mental Protection Agency (EPA). e energy transition created an opportunity for researchers "to Inhaler digital sensors help correlate reductions in power plant emissions and improvements in asthma continued on page 27 analyze the impact of the coal- red power plant energy transitions on residents' respiratory health." A study of 207 people in Je erson County (which includes Louis- ville) evaluated the frequency of asthma rescue medication usage and the total number of asth- ma-related emergency room visits and hospitalizations per ZIP code. Findings showed that energy transitions in the spring of 2015 resulted in three fewer hospitaliza- tions and emergency department visits per ZIP code per quarter in the following year, when com- pared to areas of high coal- red power plant emission exposure prior to the transition. ose results translated to nearly 400 avoided emergency department visits and hospitalizations each year across Je erson County. Further, a sulfur dioxide scrubber installed at the Mill Creek power plant (in the greater Louisville area) in June 2016 was associated with a 17% immediate reduction in rescue medication use, which continued to be maintained. e study also found the odds of hav- ing high rescue medication use throughout a month (on average more than four pu s per day) was reduced by 32% following the June 2016 energy transition. " is study was unique in its abil- ity to measure asthma morbidity based on both hospitalizations and daily symptoms, and to lever- age an abrupt change in environ- mental exposure to more directly attribute changes in asthma exac- erbation to changes in coal- red power plant emissions," said Joan Casey, PhD, lead author of the paper and assistant professor of Emissions from a coal-burning power plant (stock photo).

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