Department of Respiratory Medicine, The First People's Hospital of Yancheng, The Fourth Affiliated Hospital of Nantong University, Jiangsu Province, 224006, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Chemosphere. 2019 Dec;237:124497. doi: 10.1016/j.chemosphere.2019.124497. Epub 2019 Jul 31.
Scarce evidence existed on the association between short-term exposure to fine particulate matter (PM) and asthma in China. In this study, we aimed to explore the relationship of PM with acute asthma exacerbation in a coastal city of China. Cases of acute asthma exacerbation were identified from hospital outpatient visits in Yancheng, China, from 2015 to 2018. We utilized the generalized additive model linked by a quasi-Poisson distribution to assess the association between PM and daily acute asthma exacerbation. Different lag structures were built, and we conducted stratification analyses by gender, age, and season. Two-pollutant models were fitted, and concentration-response (C-R) curves were pooled. A total of 3,520 cases of acute asthma exacerbation were recorded, with a daily average of 3. We observed positive and significant associations of PM on lag 1, 2, lag 02, and lag 03 day. For each 10-μg/m increase in PM (lag 02), the associated increment in asthma was 3.15% (95% CI: 0.99%, 5.31%). The association remained after adjusting for gaseous co-pollutants. We observed significant PM-asthma associations in males, patients ≤64 years, and during cold seasons. The C-R curves were positive and almost linear for total and strata-specific associations. In conclusion, this study provided robust evidence on the association of PM with acute asthma exacerbation, which may benefit future prevention strategy and policy making.
在中国，关于短期暴露于细颗粒物 (PM) 与哮喘之间的关联，证据稀缺。在这项研究中，我们旨在探讨中国沿海城市 PM 与急性哮喘恶化之间的关系。病例是从 2015 年至 2018 年中国盐城的医院门诊就诊中确定的。我们利用广义加性模型，通过拟泊松分布进行关联分析，评估 PM 与每日急性哮喘恶化之间的关系。构建了不同的滞后结构，并按性别、年龄和季节进行分层分析。拟合了双污染物模型，并汇总了浓度-反应 (C-R) 曲线。共记录了 3520 例急性哮喘恶化病例，平均每天 3 例。我们观察到 PM 在滞后 1、2、滞后 02 和滞后 03 天的第 1、2 个滞后和第 0 天有阳性和显著的关联。对于每增加 10μg/m 的 PM (滞后 02)，哮喘的相关增量为 3.15%(95%CI: 0.99%，5.31%)。在调整了气态共污染物后，这种关联仍然存在。我们观察到 PM 与哮喘的关联在男性、≤64 岁的患者和寒冷季节中更为显著。C-R 曲线对于总关联和分层特定关联均呈阳性且几乎呈线性。总之，本研究提供了 PM 与急性哮喘恶化之间关联的有力证据，这可能有益于未来的预防策略和政策制定。
