Numerous Epidemiologic studies have used remote sensing to quantify the contribution of greenness, air pollution, and wildfire smoke to asthma and other respiration outcomes. This is the first review paper to evaluate the influence of remote sensing exposures to specific outcome severity and risk factors in different ecologic settings. Literature searches utilizing PubMed and Google Scholar identified 61 unique studies published between 2009-2023, with 198 specific outcomes. Respiration specific outcomes were lower in greenness, and higher in air pollution, and in wildfire ecologic settings. Aerosol optical depth (AOD)-PM2.5 readings and specific outcomes were higher in economically developing than in economically developed countries. Prospective studies found prenatal and infant exposure to higher ambient AOD-PM2.5 concentration level readings contributed to higher childhood asthma incidence. Lung function was higher in greenness, and lower in the other two ecologic settings. Age, environment, gender, other, and total risk factors showed significant differences between health outcomes and ecologic settings. Published studies utilized physiologic mechanisms of immune, inflammation, and oxidative stress to describe obtained results. Individual and total physiologic mechanisms differed between ecologic settings. Study results were used to develop a descriptive physiologic asthma model and then use it to propose updated population-based asthma intervention program guidelines.

Optimal use of Hierarchical Bayesian Model (HBM) assembled aerosol optical depth (AOD)-PM2.5 fused surfaces in epidemiologic studies requires homogeneous temporal and spatial fused surfaces. No analytical method is available to evaluate spatial heterogeneity. The temporal case-crossover design was modified to assess the spatial association between four experimental AOD-PM2.5 fused surfaces and four respiratory-cardiovascular hospital events in 12 km2 grids. The maximum number of adjacent lag grids with significant odds ratios (ORs) identified homogeneous spatial areas (HOSAs). The largest HOSA included 5 grids (lag grids 04; 720 km2) and the smallest HOSA contained 2 grids (lag grids 01; 288 km2). Emergency department asthma and inpatient asthma, myocardial infarction, and heart failure ORs were significantly higher in rural grids without air monitors than in urban grids with air monitors at lag grids 0, 1, and 01. Rural grids had higher AOD-PM2.5 concentration levels, population density, and poverty percent than urban grids. Warm season ORs were significantly higher than cold season ORs for all health outcomes at lag grids 0, 1, 01, and 04. The possibility of elevated fine and ultrafine PM and other demographic and environmental risk factors synergistically contributing to elevated respiratory-cardiovascular chronic diseases in persons residing in rural areas was discussed