Ballester F, Soriano J B, Otero I, Rivera M L, Sunyer J, Merelles A, Verea H, Marín J, Antó J M
Epidemiology and Statistics Unit, Institut Valencià d'Estudis en Salut Pública, Spain.
Am J Epidemiol. 1999 Feb 15;149(4):315-22. doi: 10.1093/oxfordjournals.aje.a009815.
Soybean unloading in the harbor of Barcelona, Spain, has been associated with large increases in the numbers of asthma patients treated in emergency departments between 1981 and 1987. In this study, the association between asthma and soybean unloading in two other Spanish cities, Valencia and A Coruña, was assessed. Asthma admissions were retrospectively identified for the period 1993-1995, and harbor activities were investigated in each location. Two approaches were used to assess the association between asthma and soybean unloading: One used unusual asthma days (days with an unusually high number of emergency room asthma visits) as an effect measure, and the other estimated the relative increase in the daily number of emergency room visits by autoregressive Poisson regression, adjusted for meteorologic variables, seasonality, and influenza incidence. No association between unusual asthma days and soya unloading was observed in either Valencia or A Coruña, except for one particular dock in Valencia. When the association between unloaded products and the daily number of emergency asthma visits was studied, a statistically significant association was observed for unloading of soya husk (relative risk = 1.50, 95% confidence interval 1.16-1.94) and soybeans (relative risk = 1.31, 95% confidence interval 1.08-1.59) in A Coruña. In Valencia, a statistical association was found only for the unloading of soybeans at two particular docks. Although these findings support the notion that asthma outbreaks are not a common hidden condition in most harbors where soybeans are unloaded, the weak associations reported are likely to be causal. Therefore, appropriate control measures should be implemented to avoid soybean dust emissions, particularly in harbors with populations living in the vicinity.
西班牙巴塞罗那港的大豆卸载与1981年至1987年间急诊科治疗的哮喘患者数量大幅增加有关。在本研究中，评估了西班牙另外两个城市瓦伦西亚和拉科鲁尼亚哮喘与大豆卸载之间的关联。回顾性确定了1993 - 1995年期间的哮喘住院病例，并调查了每个地点的港口活动。采用两种方法评估哮喘与大豆卸载之间的关联：一种方法使用异常哮喘日（急诊室哮喘就诊人数异常多的日子）作为效应量度，另一种方法通过自回归泊松回归估计急诊室每日就诊人数的相对增加，并对气象变量、季节性和流感发病率进行了调整。在瓦伦西亚或拉科鲁尼亚，除了瓦伦西亚的一个特定码头外，未观察到异常哮喘日与大豆卸载之间的关联。在研究卸载产品与每日急诊哮喘就诊人数之间的关联时，在拉科鲁尼亚观察到大豆皮卸载（相对风险 = 1.50，95%置信区间1.16 - 1.94）和大豆卸载（相对风险 = 1.31，95%置信区间1.08 - 1.59）之间存在统计学显著关联。在瓦伦西亚，仅在两个特定码头的大豆卸载中发现了统计学关联。尽管这些发现支持这样一种观点，即在大多数卸载大豆的港口，哮喘爆发并非常见的隐性情况，但所报告的微弱关联可能具有因果关系。因此，应采取适当的控制措施以避免大豆粉尘排放，特别是在附近有居民居住的港口。
