Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto, 606-8501, Japan,
Environ Health Prev Med. 2013 Sep;18(5):401-6. doi: 10.1007/s12199-013-0339-5. Epub 2013 May 3.
The association of outdoor air pollution and meteorological elements with primary care visits at night due to asthma attack was studied.
A case-crossover study was conducted in a primary care clinic in Himeji City, Japan. The subjects were 956 children aged 0-14 years who visited the clinic with an asthma attack between the hours of 9 p.m. and 6 a.m. Daily concentrations of particulate matter, ozone, nitrogen dioxide, and a number of meteorological elements were measured, and a conditional logistic regression model was used to estimate odds ratios (ORs) of primary care visits per unit increment of air pollutants or meteorological elements. The analyses took into consideration the effects of seasonality.
Of the 956 children, 73 (7.6 %) were aged <2 years and 417 (43.6 %) were aged 2-5 years. No association between daily ozone levels and primary care visits due to asthma attack at night in the spring or summer was found. An inverse relation between suspended particulate matter and primary care visits due to asthma attack was detected in the winter. ORs in the summer per degree increment in daily mean temperature was 1.31 [95 % confidential interval (CI) 1.09-1.56], and ORs in the autumn per hourly increment in daily hours of sunshine was 0.94 (95 % CI 0.90-0.99).
The findings of our study fail to support any association between daily mean concentration of air pollutant and primary care visits at night. However, we did find evidence indicating that certain meteorological elements may be associated with primary care visits.
研究由于哮喘发作导致的夜间初级保健就诊与室外空气污染和气象要素的关系。
本研究在日本兵库县姬路市的一家初级保健诊所进行了病例交叉研究。研究对象为 956 名年龄在 0-14 岁之间、夜间(晚上 9 点至早上 6 点)因哮喘发作前往诊所就诊的儿童。每日测量颗粒物、臭氧、二氧化氮和多种气象要素的浓度,并使用条件逻辑回归模型估计每单位空气污染物或气象要素增量的初级保健就诊的比值比(OR)。分析考虑了季节性的影响。
在 956 名儿童中,73 名(7.6%)年龄<2 岁,417 名(43.6%)年龄为 2-5 岁。在春季或夏季,未发现每日臭氧水平与夜间因哮喘发作而进行的初级保健就诊之间存在关联。在冬季,发现悬浮颗粒物与因哮喘发作而进行的初级保健就诊之间呈负相关。夏季每日平均气温每升高 1 度,OR 值为 1.31(95%置信区间(CI)为 1.09-1.56),秋季每日日照小时数每小时增加 1 小时,OR 值为 0.94(95%CI 为 0.90-0.99)。
我们的研究结果未能支持每日空气污染物平均浓度与夜间初级保健就诊之间的任何关联。然而,我们确实发现了某些气象要素可能与初级保健就诊相关的证据。