School of Earth Sciences, University of Melbourne, Parkville, Victoria, Australia.
Institute of Breathing and Sleep, Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
PLoS One. 2018 Apr 12;13(4):e0194929. doi: 10.1371/journal.pone.0194929. eCollection 2018.
We examine the seasonality of asthma-related hospital admissions in Melbourne, Australia, in particular the contribution and predictability of episodic thunderstorm asthma. Using a time-series ecological approach based on asthma admissions to Melbourne metropolitan hospitals, we identified seasonal peaks in asthma admissions that were centred in late February, June and mid-November. These peaks were most likely due to the return to school, winter viral infections and seasonal allergies, respectively. We performed non-linear statistical regression to predict daily admission rates as functions of the seasonal cycle, weather conditions, reported thunderstorms, pollen counts and air quality. Important predictor variables were the seasonal cycle and mean relative humidity in the preceding two weeks, with higher humidity associated with higher asthma admissions. Although various attempts were made to model asthma admissions, none of the models explained substantially more variation above that associated with the annual cycle. We also identified a list of high asthma admissions days (HAADs). Most HAADs fell in the late-February return-to-school peak and the November allergy peak, with the latter containing the greatest number of daily admissions. Many HAADs in the spring allergy peak may represent episodes of thunderstorm asthma, as they were associated with rainfall, thunderstorms, high ambient grass pollen levels and high humidity, a finding that suggests thunderstorm asthma is a recurrent phenomenon in Melbourne that occurs roughly once per five years. The rarity of thunderstorm asthma events makes prediction challenging, underscoring the importance of maintaining high standards of asthma management, both for patients and health professionals, especially during late spring and early summer.
我们研究了澳大利亚墨尔本与哮喘相关的住院季节性变化，特别是突发性雷暴哮喘的影响和可预测性。通过基于墨尔本大都市医院哮喘住院数据的时间序列生态方法，我们确定了哮喘住院季节性高峰，主要集中在 2 月下旬、6 月和 11 月中旬。这些高峰可能分别与返校、冬季病毒感染和季节性过敏有关。我们进行了非线性统计回归，以预测每日入院率作为季节性周期、天气条件、报告的雷暴、花粉计数和空气质量的函数。重要的预测变量是前两周的季节性周期和平均相对湿度，较高的湿度与较高的哮喘入院率相关。尽管我们尝试了各种方法来模拟哮喘入院，但没有一种模型能够在与年度周期相关的基础上解释更多的变化。我们还确定了一份高哮喘入院日（HAAD）清单。大多数 HAAD 都发生在 2 月下旬返校高峰和 11 月过敏高峰期间，后者包含的每日入院人数最多。春季过敏高峰中的许多 HAAD 可能代表突发性雷暴哮喘发作，因为它们与降雨、雷暴、高环境草花粉水平和高湿度有关，这一发现表明雷暴哮喘在墨尔本是一种反复出现的现象，大约每五年发生一次。雷暴哮喘事件的罕见性使得预测具有挑战性，这突显了保持高标准哮喘管理的重要性，不仅对患者，而且对卫生专业人员都很重要，尤其是在春末和初夏。
