德克萨斯州埃尔帕索因哮喘和急性支气管炎住院人数：年龄、性别和保险状况是否会改变灰尘和低风速事件的影响？
Hospital admissions for asthma and acute bronchitis in El Paso, Texas: do age, sex, and insurance status modify the effects of dust and low wind events?
机构信息
Department of Sociology and Anthropology, University of Texas at El Paso, 500W. University Ave., El Paso, TX 79902, USA.
出版信息
Environ Res. 2011 Nov;111(8):1148-55. doi: 10.1016/j.envres.2011.06.007. Epub 2011 Jul 23.
BACKGROUND
El Paso County (Texas) is prone to still air inversions and is one of the dust "hot spots" in North America. In this context, we examined the sub-lethal effects of airborne dust and low wind events on human respiratory health (i.e., asthma and acute bronchitis) between 2000 and 2003, when 110 dust and 157 low wind events occurred. Because environmental conditions may not affect everyone the same, we explored the effects of dust and low wind within three age groups (children, adults, and the elderly), testing for effect modifications by sex and insurance status, while controlling for weather and air pollutants.
METHODS
We used a case-crossover design using events matched with referent days on the same day-of-the-week, month, and year with conditional logistic regression to estimate the probability of hospital admission, while controlling for apparent temperature (lag 1), nitrogen dioxide, and particulate matter of 2.5μm or less.
RESULTS
Children (aged 1-17) were 1.19 (95% confidence interval: 1.00-1.41) times more likely to be hospitalized for asthma three days after a low wind event, and 1.33 (95% CI: 1.01-1.75) times more likely to be hospitalized for acute bronchitis one day after a dust event than on a clear day. Girls were more sensitive to acute bronchitis hospitalizations after dust events (1.83, 95% CI: 1.09-3.08) than boys, but less sensitive than boys to acute bronchitis hospitalizations after low wind events (0.68, 95% CI: 0.46-1.00). We found general trends with regard to dust and low wind events being associated with increased odds of hospitalization for asthma and bronchitis amongst all ages and adults (aged 18-64). Adults covered by Medicaid and adults without health insurance had higher risks of hospitalization for asthma and acute bronchitis after both low wind and dust events.
CONCLUSIONS
Results suggest that there were respiratory health effects associated with dust and low wind events in El Paso, with stronger impacts among children and poor adults. Girls and boys with acute bronchitis were differentially sensitive to dust and low wind events.
背景
埃尔帕索县（德克萨斯州）容易出现静风逆温，并且是北美扬尘“热点”之一。在此背景下，我们在 2000 年至 2003 年期间，研究了空气中的扬尘和低风速事件对人类呼吸健康（即哮喘和急性支气管炎）的亚致死影响，当时共发生了 110 次扬尘事件和 157 次低风速事件。由于环境条件可能对每个人的影响不同，我们在三个年龄组（儿童、成年人和老年人）内研究了扬尘和低风速的影响，检验了性别和保险状况的效应修饰作用，同时控制了天气和空气污染物。
方法
我们使用病例交叉设计，将事件与同一周、月和年的参考日进行匹配，并使用条件逻辑回归来估计住院的概率，同时控制滞后 1 天的表观温度、二氧化氮和 2.5μm 以下的颗粒物。
结果
儿童（1-17 岁）在低风速事件发生后三天因哮喘住院的可能性是无扬尘日的 1.19 倍（95%置信区间：1.00-1.41），在扬尘事件发生后一天因急性支气管炎住院的可能性是无扬尘日的 1.33 倍（95%置信区间：1.01-1.75）。女孩在扬尘事件后发生急性支气管炎住院的敏感性高于男孩（1.83，95%置信区间：1.09-3.08），但在低风速事件后发生急性支气管炎住院的敏感性低于男孩（0.68，95%置信区间：0.46-1.00）。我们发现，在所有年龄段和成年人（18-64 岁）中，扬尘和低风速事件与哮喘和支气管炎住院的几率增加均呈普遍趋势。接受医疗补助和没有医疗保险的成年人在低风速和扬尘事件后，哮喘和急性支气管炎住院的风险更高。
结论
结果表明，埃尔帕索县的扬尘和低风速事件与呼吸健康有关，儿童和贫困成年人的影响更大。患有急性支气管炎的女孩和男孩对扬尘和低风速事件的敏感性不同。
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