From the aDepartment of Public Health and Health Policy, Graduate school of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan; bDepartment of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Kita-ku, Okayama, Japan; cDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Kita-ku, Okayama, Japan; and dDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Epidemiology. 2017 Oct;28 Suppl 1:S60-S66. doi: 10.1097/EDE.0000000000000700.
Factors influencing the susceptibility of the elderly to the adverse health effects of short-term exposure to desert dust have yet to be explored. We aimed to identify the disease histories that increase the susceptibility of the elderly to disease onset induced by dust events.
We used a time-stratified case-crossover design using data on 17,874 elderly residents (≥65 years) of Okayama, Japan, who were transported to hospital emergency rooms because of cardiovascular and respiratory diseases between 2006 and 2010. We used conditional logistic models to calculate the odds ratios (ORs) per interquartile increase of Asian dust. We then conducted stratified analyses based on patients with or without a history of chronic disease.
Dust concentration was associated with a higher risk of cardiovascular (3-day lag), cerebrovascular (same day), and respiratory (3-day lag) disease onset. Patients with a history of respiratory disease had a higher risk of cardiovascular (OR: 1.09 [95% confidence interval (CI) = 1.00, 1.19] vs. 0.99 [0.97, 1.01]; P for interaction = 0.03) or cerebrovascular (1.15 [1.01, 1.31] vs. 0.99 [0.97, 1.01]; P = 0.02) disease onset (2-day lag) than those without. Patients with diabetes also had a higher risk of cerebrovascular disease onset (1.09 [1.00, 1.19] vs. 0.99 [0.97, 1.01]; P = 0.05) (2-day lag). In contrast, patients with a history of cerebrovascular disease had a lower risk of respiratory disease.
People with a history of respiratory disease or diabetes might have a greater susceptibility to cardiovascular disease from Asian dust and would therefore benefit from proactive interventions during desert dust events.
影响老年人短期暴露于沙尘环境下健康不良影响易感性的因素尚未得到探索。我们旨在确定增加老年人因尘暴事件而发病易感性的疾病史。
我们使用时间分层病例交叉设计，使用日本冈山县 2006 年至 2010 年间因心血管和呼吸系统疾病被送往医院急诊室的 17874 名（≥65 岁）老年居民的数据。我们使用条件逻辑模型计算每四分位距增加的亚洲沙尘的比值比（OR）。然后，我们根据是否有慢性病史进行分层分析。
沙尘浓度与心血管疾病（3 天滞后）、脑血管疾病（当日）和呼吸系统疾病（3 天滞后）发病风险增加相关。有呼吸系统疾病史的患者发生心血管疾病（OR：1.09[95%置信区间（CI）=1.00，1.19]比 0.99[0.97，1.01]；P 交互=0.03）或脑血管疾病（1.15[1.01，1.31]比 0.99[0.97，1.01]；P=0.02）发病的风险更高（2 天滞后），而无该病史的患者则更低。患有糖尿病的患者也有更高的脑血管疾病发病风险（1.09[1.00，1.19]比 0.99[0.97，1.01]；P=0.05）（2 天滞后）。相反，有脑血管疾病史的患者发生呼吸系统疾病的风险较低。
有呼吸系统疾病或糖尿病史的人可能更容易受到亚洲沙尘的心血管疾病影响，因此在沙尘天气期间需要采取积极的干预措施。
