Environmental intelligence is unlocking new ways to monitor childhood asthma

"Kids want to move. Young adults want to move. They want to be on the go. They want to feel good. So that's debilitating for a younger person."

Our Senior Vice President, Craig Stelmach, recently interviewed Edgar Delgado Echart, Research Group Leader at the University of Basel and Children's Hospital. These were Craig's closing words, and they stayed with us.

Asthma in children affects entire families. Last year, the BBC published an article featuring 13-year-old Emily Albino, who died following an asthma attack that her parents described as the result of "a series of systemic failures." According to the report, not enough people paid attention to Emily's condition, which was further worsened by anxiety.

This grief and suffering are the reality for an estimated 8% to 15% of children worldwide, as Edgar pointed out.

But things will not remain this way. When Edgar approached Ambee to use our real-time, hyperlocal environmental data for Project ALEX, he helped catalyze the development of a digital tool designed to support asthma management for children in a middle-income country like Romania.

Why does childhood asthma remain uncontrolled?

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Despite advances in treatment, childhood asthma remains difficult to manage. The challenge is not just the disease itself, but how asthma is monitored and treated today.

• Asthma symptoms can change rapidly, while clinical visits happen only a few times a year
• Doctors often rely on parents and children remembering symptoms that occurred weeks or months earlier, leading to gaps in information
• Young children may not recognize worsening symptoms or may hide them altogether
• Opportunities for early intervention are frequently missed between appointments

Even this level of monitoring remains out of reach for many children in low and middle-income countries, where environmental exposures are often higher and access to healthcare is more limited.

A study conducted in the South African townships of Mabopane and Soshanguve highlights this reality. In communities facing high levels of poverty and unemployment, frequent power outages and energy costs force families to rely on gas stoves, paraffin heaters, wood, and coal for cooking and heating. These solutions significantly increase indoor air pollution, where children spend much of their time. Researchers found that severe asthma symptoms affected roughly one in six children.

For these children, asthma management is also an environmental challenge.

How can we close these gaps if we can't control the environment?

Edgar explains that many patients experience severe symptoms only during specific periods of the year, particularly when certain pollen species are released, while remaining largely symptom-free during other seasons. 

Edgar pointed out, “We’re partnering with five different hospitals in Romania, and they all confirmed that many of the patients are not fully aware of what is the impact of environmental exposures on their asthma.”

Project ALEX analyzed environmental factors such as allergens, air pollution, seasonality, and regional differences across Romania. The study also considered how local topography influences exposure, helping identify the times and locations where environmental conditions are most likely to trigger asthma symptoms.

Nobody can change the air quality of their neighborhood or eliminate pollen from the air.

Edgar points to a major blind spot in traditional asthma management: most patients are monitored at home, while much of their day is spent elsewhere.

A child may leave home with no apparent environmental risk, only to spend several hours at a school surrounded by different vegetation, pollutants, or weather conditions. If clinicians only look at exposure data linked to a home address, they may never understand why symptoms worsen on certain days.

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As Edgar explains, exposure can vary dramatically even within the same city. Wind patterns, buildings, terrain, traffic corridors, and local vegetation can create very different environmental conditions just a few kilometers apart. A city-wide average or a single monitoring station may show normal conditions while a child is experiencing significant exposure elsewhere.

This is where hyperlocal environmental intelligence becomes valuable. Instead of relying on broad regional measurements, Project ALEX can understand the environmental conditions surrounding a child throughout their daily routine, whether at home, school, or elsewhere.

The goal is to identify environmental triggers early enough to anticipate worsening symptoms, personalize care, and intervene before an asthma attack occurs.

What is Project ALEX doing differently?

Traditional asthma care relies on occasional clinic visits and patient recall. Project ALEX takes a very different approach by continuously monitoring asthma through a combination of connected devices, digital engagement, and environmental intelligence.

Children in the study use a portable spirometer every day to measure lung function, providing an objective view of how their airways are performing over time. They also complete regular symptom questionnaires, while a sensor attached to their inhaler tracks medication use automatically, giving researchers a clear picture of treatment adherence.

To keep young patients engaged, Project ALEX incorporates gamification. Children earn rewards for consistently completing their monitoring activities, helping transform a medical routine into a habit they are more likely to maintain.

The project also captures information passively. Participants wear a smartwatch during sleep, allowing researchers to monitor sleep quality, nighttime awakenings, and other indicators that may signal worsening asthma. By comparing these passive signals with traditional measures such as spirometry and symptom reports, the team hopes to identify new ways of assessing asthma without requiring constant effort from patients.

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How is this changing asthma care in Romania?

By putting timely environmental information into the hands of patients, parents, and healthcare providers in Romania, Project ALEX helps explain why symptoms worsen and what actions can be taken in response.

Families stop viewing asthma attacks as unpredictable events and begin connecting symptoms to real-world triggers such as pollen, air pollution, and changing environmental conditions.

When patients understand their exposures, they can adjust their daily routines, prepare medication in advance, and avoid high-risk environments when possible.

Around the world, healthcare organizations, consumer brands, and digital health platforms are increasingly recognizing that environmental exposure is a missing piece of the health puzzle.

One example is Kimberly-Clark's Pollen Pal, powered by Ambee's hyperlocal, real-time pollen intelligence. Built to help allergy sufferers understand and respond to pollen exposure, the platform gives users visibility into local pollen conditions before symptoms escalate.

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Read our Pollen Pal case study to see how Kimberly-Clark and Ambee turned environmental awareness into clinical monitoring.

Ambee provides hyperlocal historical, real-time, forecast, and continuously refreshed environmental intelligence that helps researchers, healthcare organizations, digital health platforms, consumer brands, insurers, and enterprises understand the impact of environmental exposure.

If environmental conditions influence the decisions you make and the people you serve, connect with our team to explore how these datasets can support your specific use case.

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