Marginal Asthma Prevalence from NOx Emissions (MANE): A Model to Predict Pediatric Asthma Burden from Emissions of Nitrogen Oxides.

Pediatric asthma affects roughly 1 in 15 children in the U.S., with significantly higher rates in Black children. Exposure to NO2 contributes to asthma development, but quantitative analysis of pediatric asthma burden attributable to NOx emissions is rarely performed due to a lack of suitable models. This paper describes a new model, Marginal Asthma prevalence from NOx Emissions (MANE), which assesses the pediatric asthma burden from NOx emissions and its distribution across race/ethnicities. We find that emissions in more densely populated areas cause a larger number of pediatric asthma cases and tend to disproportionately impact minority communities. We applied our model to assess the pediatric asthma burden from sources of NOx, finding that diesel heavy-duty vehicles are responsible for approximately 4% of all pediatric asthma cases in the U.S. Additionally, we find that all source sectors considered disproportionately impact children of color, with 65-100% higher per-capita asthma rates in Black children compared to white non-Hispanic children. Finally, we find that emissions in a limited number of urban areas are responsible for a large share of asthma cases, suggesting that local, targeted restrictions on NOx emissions may provide great public health benefit nationally.