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Global climate change produces increasing episodes of extreme heat, a public health problem affecting the chronically ill and children. Children’s risk is due to developing physiology, their behaviors and activity. Asthma, a chronic respiratory disease with no cure, has lifelong adverse effects. This review examines the association between extreme ambient heat and childhood asthma morbidity. A scoping literature review searched PubMed, Scopus and ProQuest for papers published between January 1, 2018 and October 1, 2023. Of 668 articles sourced focusing on heat extremes, morbidity from asthma and effects on children, 8 studies were used in the review.

While all studies but one produced measures showing association between ambient heat and asthma exacerbation, many concluded it was not significant. All studies were retrospective, including six cohort studies, one case crossover analysis and one case control. All used identical diagnostic codes for asthma outcomes. Challenging to the comparability of results was the variability in: (i.) temperature definition; (ii.) regional climactic conditions which defined temperature as extreme in one locale not comparable to another; (iii.) treatment locales, such as emergency room versus outpatient, possibly indicating different levels of exacerbation. Many studies found that school age children were most affected; others variously found differences between males and females or ethnic groups. More uniform study design across more geographies would enhance understanding the effect of extreme ambient heat on childhood asthma. Prospective studies would allow researchers to better control confounders and study behavioral issues and mechanisms of effect directly