SAEMF/ADIEM Research Grant - $6,000

Understanding acute precipitants of sickle cell exacerbation holds the potential to inform pre-hospital intervention, change emergency department (ED) management, and ultimately slow disease progression. Sickle cell disease (SCD) disproportionately impacts U.S. individuals of African descent with over 90% of patients identifying as non-Hispanic Black or African American and is associated with a twenty-year reduction in life expectancy. The lives of children with SCD are punctuated by recurrent, unpredictable episodes of severe vaso-occlusive pain resulting in frequent visits to the ED. Young persons with SCD with high ED utilization have a higher likelihood of residing in socially vulnerable neighborhoods and have increased risk of death and premature death.

In an era of accelerated climate change, there is increasing scholarly and clinical interest in the impact of extreme weather events on sickle cell decompensations. Within existing literature on SCD, interactions between temperature, humidity, and ambient air pollutant levels, and increased risk for dehydration during extreme heat events have been cited as plausible mechanisms for a clinically significant association. A focused investigation into short-term air pollutant exposures is all the more salient in a regional landscape of increasingly frequent wildfires and changes in regional traffic emissions policies and emissions compositions.The proposed study will characterize the association between short-term ambient air quality and pediatric ED presentation for SCD decompensations. It is foundational to subsequent planned work that will provide greater insight into the etiologies of sickle cell exacerbation, necessitating an opportunity for an educational intervention for ED providers, patients and families with the possibility of both honing predictions of clinical course and improving clinical outcomes. It contributes instrumental data elucidating acute care needs in a historically medically and socially disadvantaged population as those needs intersect with environmental health and markers of climate change.