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湿热暴露对中国合肥儿童哮喘住院风险的影响:性别和年龄的调节作用。

Impacts of exposure to humidex on the risk of childhood asthma hospitalizations in Hefei, China: Effect modification by gender and age.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.

Anhui province Children's hospital, China.

出版信息

Sci Total Environ. 2019 Nov 15;691:296-305. doi: 10.1016/j.scitotenv.2019.07.026. Epub 2019 Jul 3.

Abstract

BACKGROUND

With global climate change, there is growing concern about the effects of temperature changes on childhood asthma. However, current research only focuses on the effects of temperature, while ignoring the adverse effects of humidity on children.

OBJECTIVES

Our study aimed to quantify the impact of humidex on childhood asthma hospitalizations, which combined temperature and humidity, and further to assess how the effect is modified by individual-factors, such as age and gender.

METHODS

Poisson generalized linear models combined with distributed lag nonlinear models were used to estimate the association between daily childhood asthma hospitalizations and humidex from 2013 to 2016. Air pollutions (CO, O and NO) and wind velocity were modelled simultaneously using DLNM, as well as day of week, seasonality and long-term trend.

RESULTS

Low humidex was associated with an increased risk of admissions for asthma in children. The adverse effect appeared on the 4th day, with the RR of 1.045 (95%CI: 1.007-1.084) and lasted until the 7th day (RR: 1.045, 95%CI: 1.006-1.085). Compared with the male, there was an immediate effect on female exposed to low humidex. And the female seems to be more sensitive to low humidex. Besides, the significant effects of humidex on children asthma were detected in the children with preschool and school-age, whereas not for the subgroup of infants. And the school-age children are most sensitive to low humidex.

CONCLUSIONS

Low humidex was associated with the increased risk of admissions for childhood asthma in Hefei. Children suffering from asthma should avoid exposure to the low humidex environment, especially in female and school-age children. In addition, the index of humidex was more significant for disease prevention and public health than the average temperature. These findings may provide epidemiology evidence for formulating precaution guidelines to reduce the risk of childhood asthma hospitalizations.

摘要

背景

随着全球气候变化,人们越来越关注温度变化对儿童哮喘的影响。然而,目前的研究仅关注温度的影响,而忽略了湿度对儿童的不利影响。

目的

本研究旨在量化湿热指数对儿童哮喘住院的影响,该指数综合了温度和湿度,并进一步评估个体因素(如年龄和性别)对其影响的修正作用。

方法

采用泊松广义线性模型结合分布滞后非线性模型,估计 2013 年至 2016 年期间每日儿童哮喘住院与湿热指数之间的关联。采用 DLNM 同时对空气污染物(CO、O 和 NO)和风速进行建模,以及星期几、季节性和长期趋势。

结果

低湿热指数与儿童哮喘住院风险增加有关。这种不良影响出现在第 4 天,RR 为 1.045(95%CI:1.007-1.084),并持续到第 7 天(RR:1.045,95%CI:1.006-1.085)。与男性相比,暴露于低湿热指数的女性存在即时效应。而且,女性对低湿热指数似乎更为敏感。此外,在学龄前和学龄儿童中检测到湿热指数对儿童哮喘的显著影响,而在婴儿亚组中则没有。学龄儿童对低湿热指数最为敏感。

结论

低湿热指数与合肥市儿童哮喘住院风险增加有关。患有哮喘的儿童应避免暴露于低湿热环境中,尤其是女性和学龄儿童。此外,与平均温度相比,湿热指数对疾病预防和公共卫生更为重要。这些发现为制定预防指南以降低儿童哮喘住院风险提供了流行病学证据。

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