Tse Kevin, Chen Lie, Tse Mabel, Zuraw Bruce, Christiansen Sandra
Department of Allergy, Kaiser Permanente Medical Center, San Diego, California; Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of California at San Diego, La Jolla, California.
Department of Research and Evaluation, Kaiser Permanente Medical Center, Pasadena, California.
Ann Allergy Asthma Immunol. 2015 Apr;114(4):308-311.e4. doi: 10.1016/j.anai.2015.01.018. Epub 2015 Mar 4.
Air pollutants from wildfires and obesity independently exacerbate asthma, yet no study has determined the combined effects of these 2 variables on asthma outcomes.
To determine the effect of 2 catastrophic wildfires affecting the Southern California region (in 2003 and 2007) on several asthma outcomes in a cohort of children.
To investigate the association between wildfire exposure and asthma outcomes, we stratified our study population by body mass index categories (underweight, normal, overweight, and obese) and zip codes (to distinguish individuals who were closer to the fires vs farther away). The primary outcome was the prevalence of physician-dispensed short-acting β-agonist (SABAs). Secondary outcomes included the rate of emergency department visits and/or hospitalizations for asthma, the frequency of oral corticosteroid use for asthma, and number of new diagnoses of asthma.
A total of 2,195 and 3,965 asthmatic children were analyzed as part of our retrospective cohort during the 2003 and 2007 wildfires, respectively. SABA dispensing increased the most in the obese group after the 2003 wildfires (P < .05). Increased prevalence of SABA dispensing was also noted in the obese group in 2007, but this was not statistically higher than the increases seen in other body mass index groups. There was no observed increase in emergency department and/or hospitalization rates, oral corticosteroid dispensing frequency, or new asthma diagnoses after either wildfire.
Catastrophic wildfires lead to worsening asthma outcomes, particularly in obese individuals. This study gives further evidence of a link between obesity and asthma severity and suggests that air pollutants released during wildfires can have substantial detrimental effects on asthma control.
野火产生的空气污染物和肥胖各自都会加重哮喘，但尚无研究确定这两个变量对哮喘结局的综合影响。
确定两场影响南加州地区的灾难性野火（2003年和2007年）对一组儿童若干哮喘结局的影响。
为了研究野火暴露与哮喘结局之间的关联，我们按体重指数类别（体重过轻、正常、超重和肥胖）以及邮政编码（以区分距离火灾较近与较远的个体）对研究人群进行分层。主要结局是医生开具的短效β-激动剂（SABA）的使用率。次要结局包括因哮喘就诊急诊科和/或住院的比率、哮喘口服糖皮质激素的使用频率以及哮喘新诊断病例数。
在2003年和2007年野火期间，分别有2195名和3965名哮喘儿童作为我们回顾性队列研究的一部分进行了分析。2003年野火后，肥胖组的SABA开具增加最多（P < 0.05）。2007年肥胖组的SABA开具率也有所增加，但在统计学上并不高于其他体重指数组的增加幅度。两场野火后，均未观察到急诊科就诊率和/或住院率、口服糖皮质激素开具频率或哮喘新诊断病例数增加。
灾难性野火会导致哮喘结局恶化，尤其是在肥胖个体中。这项研究进一步证明了肥胖与哮喘严重程度之间的联系，并表明野火期间释放的空气污染物可能对哮喘控制产生重大不利影响。
