Marginal Asthma Prevalence from NO_<i>x</i> 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 NO_<i>x</i> emissions is rarely performed due to a lack of suitable models. This paper describes a new model, Marginal Asthma prevalence from NO_<i>x</i> Emissions (MANE), which assesses the pediatric asthma burden from NO_<i>x</i> 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 NO_<i>x</i>, 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 NO_<i>x</i> emissions may provide great public health benefit nationally.