Department of Respiratory and Sleep Medicine, Eastern Health, Melbourne, Victoria, Australia.
Office of Research and Ethics, Eastern Health, Melbourne, Victoria, Australia.
Intern Med J. 2019 Jan;49(1):74-78. doi: 10.1111/imj.13800.
Epidemic thunderstorm asthma (ETSA) refers to large-scale acute bronchospasm events associated with thunderstorm. The most serious episode ever recorded occurred in Melbourne, Australia, in November 2016, where more than 3500 patients were treated in hospitals and 10 died. Previous work has been focused primarily on patient presentations to emergency departments. The prevalence of individuals with milder, non-emergent symptoms and who may be at risk of more serious episodes in the future has not previously been explored.
To characterise the nature and extent of respiratory symptoms in healthcare workers during the Melbourne ETSA event.
A survey was conducted among staff and volunteers across Eastern Health, distributed on the intranet homepage, by email and by word of mouth. Anonymous survey questions were constructed to assess prior and current diagnoses of relevance, symptoms, and demography.
There were 515 participants (80% female, n = 411) of approximately 9000 potential respondents (~6% response rate) who completed the survey; 132 (25.6%) had symptoms suggestive of asthma during the Melbourne ETSA event, the majority of whom did not seek professional medical help. Notably, of those with ETSA-like symptoms, only 58 (43.9%) had a history of asthma, while 97 (73.5%) had a history of allergic rhinitis. Specifically, a history of allergic rhinitis (OR 2.77, P < 0.001), a history of asthma (OR 1.67, P = 0.037) and being of self-identified Asian ethnicity (OR 3.24, P < 0.001) were all strong predictors of ETSA-like symptoms. Being predominantly indoors was not protective.
Our study provides evidence of the presence of a large cohort of sufferers during the Melbourne ETSA event of 2016 that did not come to the attention of medical services, implying a potentially hidden and significant susceptible population. Further research should help clarify the true prevalence of vulnerability in the general population, with important public health implications.
暴发性雷暴哮喘（ETSA）是指与雷暴相关的大规模急性支气管痉挛事件。有记录以来最严重的一次发生在 2016 年 11 月的澳大利亚墨尔本，当时有超过 3500 名患者在医院接受治疗，有 10 人死亡。以前的研究主要集中在急诊科就诊的患者。以前没有探讨过患有更轻微、非紧急症状的个体以及未来可能出现更严重发作的风险。
描述墨尔本暴发性雷暴哮喘事件期间医护人员呼吸症状的性质和程度。
在东健康医疗中心的员工和志愿者中进行了一项调查，通过内部网主页、电子邮件和口头宣传分发调查问卷。匿名调查问卷旨在评估先前和当前相关诊断、症状和人口统计学。
在大约 9000 名潜在受访者中，有 515 名（80%为女性，n=411）完成了调查；在墨尔本暴发性雷暴哮喘事件期间，有 132 名（25.6%）出现哮喘样症状，其中大多数人没有寻求专业医疗帮助。值得注意的是，在有暴发性雷暴哮喘样症状的人群中，仅有 58 人（43.9%）有哮喘病史，而 97 人（73.5%）有过敏性鼻炎病史。具体而言，过敏性鼻炎病史（OR 2.77，P<0.001）、哮喘病史（OR 1.67，P=0.037）和自认为是亚洲种族（OR 3.24，P<0.001）均是暴发性雷暴哮喘样症状的强预测因素。主要在室内活动并没有起到保护作用。
我们的研究提供了证据，表明在 2016 年墨尔本暴发性雷暴哮喘事件中有大量哮喘患者未引起医疗服务部门的注意，这暗示着存在一个潜在的、数量庞大的易感人群。进一步的研究应该有助于阐明一般人群中易感性的真实流行率，这具有重要的公共卫生意义。
