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2005年至2011年美国加利福尼亚州的甲基溴与哮喘急诊就诊情况

Methyl-bromide and asthma emergency department visits in California, USA from 2005 to 2011.

作者信息

Gharibi Hamed, Entwistle Marcela R, Schweizer Donald, Tavallali Pooya, Thao Chia, Cisneros Ricardo

机构信息

Health Sciences Research Institute, University of California, Merced, Merced, CA, USA.

USDA Forest Service, Pacific Southwest Region, Clovis, CA, USA.

出版信息

J Asthma. 2020 Nov;57(11):1227-1236. doi: 10.1080/02770903.2019.1645167. Epub 2019 Jul 31.

Abstract

Urban monitors of Methyl bromide (MBr), not typically near application sites, are used to investigate the impact of ambient concentrations on asthma Emergency Department (ED) visits. 4262 ED visits from August to February of 2005 to 2011 in Central and Southern California were selected from California's Office of Statewide Health Planning and Development (OSHPD). A bidirectional-symmetric case-crossover study design using conditional logistic regression model was used to obtain the odds ratio (OR) and 95% confidence interval associated with a 0.01 ppb (interquartile range) increase in MBr. The population sample was comprised of 46.0% male and 53.9% females. Ethnic groups included 32.0% Non-Hispanic White, 23.5% Non-Hispanic Black, and 44.4% Hispanic. Age distribution was between 2 and 5 years old (11.6%), 6 and 18 years old (23.5%), 19 and 40 years old (29.3%), 41 and 64 years old (24.1%), and 65 or older (6.9%). There was a positive association between MBr and asthma ED visits among Non-Hispanic Blacks [OR: 1.065 (95% confidence intervals: 1.019, 1.108)] and Hispanics [OR: 1.107 (95% confidence intervals: 1.043, 1.173)], while Non-Hispanic Whites did not have an association with asthma ED visits. Positive association between MBr and asthma ED visits was found only among 6 to 18 [OR: 1.071 (95% confidence intervals: 1.016, 1.125)] years old. An increase in MBr concentration was found to be associated with an increase of the odds of having asthma ED visits in California among 6 to 18 years old and disproportionately affects Non-Hispanic Blacks and Hispanics over Non-Hispanic Whites.

摘要

城市中监测的甲基溴(MBr)通常不在施用地点附近,用于调查环境浓度对哮喘急诊就诊的影响。从加利福尼亚州全州卫生规划与发展办公室(OSHPD)选取了2005年8月至2011年2月在加利福尼亚州中部和南部的4262例急诊就诊病例。采用条件逻辑回归模型的双向对称病例交叉研究设计,以获取与MBr浓度每增加0.01 ppb(四分位间距)相关的优势比(OR)和95%置信区间。总体样本中男性占46.0%,女性占53.9%。种族群体包括32.0%的非西班牙裔白人、23.5%的非西班牙裔黑人以及44.4%的西班牙裔。年龄分布在2至5岁(11.6%)、6至18岁(23.5%)、19至40岁(29.3%)、41至64岁(24.1%)以及65岁及以上(6.9%)。在非西班牙裔黑人[OR:1.065(95%置信区间:1.019,1.108)]和西班牙裔[OR:1.107(95%置信区间:1.043,1.173)]中,MBr与哮喘急诊就诊之间存在正相关,而非西班牙裔白人则与哮喘急诊就诊无关联。仅在6至18岁人群中发现MBr与哮喘急诊就诊之间存在正相关[OR:1.071(95%置信区间:1.016,1.125)]。研究发现,在加利福尼亚州,MBr浓度升高与6至18岁人群哮喘急诊就诊几率增加相关,且对非西班牙裔黑人和西班牙裔的影响大于非西班牙裔白人。

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