Schools with aging infrastructure may expose students to extreme temperatures. Extreme outdoor temperatures have previously been linked to more asthma-related health care utilization. Explore the relationship between classroom temperatures and school-based health care visits for asthma in an urban school building with an outdated heating and cooling system. Participants were students in grades K-8 who received health care from a school-based health center (SBHC) (n = 647) or school nurse (n = 1244) in 2 co-located urban public schools between 2016 and 2018. The probability of an asthma visit to the SBHC or school nurse was modeled as a function of indoor temperature exposure using generalized estimating equations with covariates accounting for grade, sex, outdoor temperature, days at risk of asthma visit, nonasthma visits, month, and year fixed effects. Classroom temperatures ranged from 48.0˚F to 100.6°F. Higher mean grade-level indoor temperatures from a baseline of approximately 70˚F to 76˚F were associated with increased rates of asthma-related visits to the SBHC or school nurse on same day of exposure. Model-generated estimates suggest that an increase of 10˚F in indoor temperature relative to a baseline of 75˚F was associated with a 53% increase in the rate of asthma-related SBHC visits. Elevated classroom temperatures may be associated with more school-based health care utilization for asthma. Low-income and students from racial and ethnic minority groups have disproportionately higher rates of asthma and are also more likely to attend schools with poor infrastructure. The potential benefits of school infrastructure investments for student health, health care costs, and health equity merit further investigation.

中文翻译：

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教室温度和与哮喘相关的学校医疗保健利用：一项探索性研究

基础设施老化的学校可能会让学生暴露在极端温度下。此前，极端的室外温度曾被认为与更多与哮喘相关的医疗保健利用有关。探索一所拥有过时供暖和制冷系统的城市学校建筑中教室温度与学校哮喘就诊之间的关系。参与者是 2016 年至 2018 年间从校内健康中心 (SBHC) (n = 647) 或 2 所位于同一地点的城市公立学校的学校护士 (n = 1244) 接受医疗保健的 K-8 年级学生。使用广义估计方程将哮喘就诊 SBHC 或学校护士的比例建模为室内温度暴露的函数，其中协变量考虑了年级、性别、室外温度、哮喘就诊风险天数、非哮喘就诊风险、月份和年份固定效应。教室温度范围为 48.0°F 至 100.6°F。较高的平均年级室内温度（从大约 70°F 到 76°F 的基线）与暴露当天因哮喘相关就诊 SBHC 或学校护士的比率增加相关。模型生成的估计表明，相对于 75°F 的基线，室内温度增加 10°F 与哮喘相关的 SBHC 就诊率增加 53% 相关。教室温度升高可能与学校更多地利用哮喘医疗保健有关。低收入群体以及少数族裔学生的哮喘发病率极高，而且更有可能就读基础设施较差的学校。学校基础设施投资对学生健康、医疗保健成本和健康公平的潜在好处值得进一步研究。