Gargano Lisa M, Thomas Pauline A, Stellman Steven D
New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Queens, New York.
Department of Preventive Medicine and Community Health, New Jersey Medical School, Rutgers University, Newark, New Jersey.
Pediatr Res. 2017 Jan;81(1-1):43-50. doi: 10.1038/pr.2016.190. Epub 2016 Sep 22.
Little is known about asthma control in adolescents who were exposed to the World Trade Center (WTC) attacks of 11 September 2001 and diagnosed with asthma after 9/11. This report examines asthma and asthma control 10-11 y after 9/11 among exposed adolescents.
The WTC Health Registry adolescent Wave 3 survey (2011-2012) collected data on asthma diagnosed by a physician after 11 September 2001, extent of asthma control based on modified National Asthma Education and Prevention Program criteria, probable mental health conditions, and behavior problems. Parents reported healthcare needs and 9/11-exposures. Logistic regression was used to evaluate associations between asthma and level of asthma control and 9/11-exposure, mental health and behavioral problems, and unmet healthcare needs.
Poorly/very poorly controlled asthma was significantly associated with a household income of ≤$75,000 (adjusted odds ratio (AOR): 3.0; 95% confidence interval (CI): 1.1-8.8), having unmet healthcare needs (AOR: 6.2; 95% CI: 1.4-27.1), and screening positive for at least one mental health condition (AOR: 5.0; 95% CI: 1.4-17.7), but not with behavioral problems. The impact of having at least one mental health condition on the level of asthma control was substantially greater in females than in males.
Comprehensive care of post-9/11 asthma in adolescents should include management of mental health-related comorbidities.
对于2001年9月11日遭受世贸中心袭击且在9·11事件后被诊断出患有哮喘的青少年的哮喘控制情况,人们了解甚少。本报告调查了9·11事件发生10 - 11年后受影响青少年的哮喘及哮喘控制情况。
世贸中心健康登记处青少年第三次调查(2011 - 2012年)收集了以下数据:2001年9月11日后由医生诊断的哮喘情况、基于修订后的国家哮喘教育与预防计划标准的哮喘控制程度、可能存在的心理健康状况以及行为问题。家长报告了医疗保健需求和9·11事件暴露情况。采用逻辑回归分析来评估哮喘与哮喘控制水平、9·11事件暴露、心理健康和行为问题以及未满足的医疗保健需求之间的关联。
哮喘控制不佳/非常不佳与家庭收入≤75,000美元(调整后的优势比(AOR):3.0;95%置信区间(CI):1.1 - 8.8)、有未满足的医疗保健需求(AOR:6.2;95% CI:1.4 - 27.1)以及至少一种心理健康状况筛查呈阳性(AOR:5.0;95% CI:1.4 - 17.7)显著相关,但与行为问题无关。至少有一种心理健康状况对哮喘控制水平的影响在女性中比在男性中要大得多。
对9·11事件后青少年哮喘的综合护理应包括对心理健康相关合并症的管理。