短期多种室外环境因素对哮喘恶化风险的影响：年龄分层时间序列分析。

Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: Age-stratified time-series analysis.

机构信息

Graduate School of Medicine, CHA University, Seongnam, Korea; Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea.

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea; Medical Corps, Republic of Korea Army, Seongnam, Korea.

出版信息

J Allergy Clin Immunol. 2019 Dec;144(6):1542-1550.e1. doi: 10.1016/j.jaci.2019.08.037. Epub 2019 Sep 16.

DOI:10.1016/j.jaci.2019.08.037

PMID:31536730

Abstract

BACKGROUND

Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs.

OBJECTIVE

We sought to examine the short-term effects in age-stratified groups (infants, preschool children, school-aged children, adults, and the elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on AEs.

METHODS

We performed an age-stratified analysis of the short-term effects of 4 groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis used a Poisson generalized linear regression model, with a distributed lag nonlinear model for identification of lagged and nonlinear effects and convergent cross-mapping for identification of causal associations.

RESULTS

Analysis of the total population (n = 10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly (relative risk [RR], 1.056-1.078 and 1.016, respectively) subjects. Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-aged children (RR, 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR, 1.026 and 1.044, respectively). Outdoor air pollutants (particulate matter of ≤10 μm in diameter, nitrogen dioxide, ozone, carbon monoxide, and sulfur dioxide) had significant short-term effects in all age groups (except for carbon monoxide and sulfur dioxide in infants).

CONCLUSION

These findings provide a need for the development of tailored strategies to prevent AE events in different age groups.

摘要

背景

尽管不同年龄组的哮喘发作（AE）对环境因素的敏感性存在差异，但尚无综合研究探讨环境因素对 AE 的年龄分层作用。

目的

我们旨在研究年龄分层组（婴儿、学龄前儿童、学龄儿童、成人和老年人）中户外环境因素（空气污染物、天气条件、气传过敏原和呼吸道病毒流行）对 AE 的短期影响。

方法

我们对 2008 年至 2012 年期间首尔市（韩国）的 4 组户外环境因素对 AE 的短期影响进行了年龄分层分析。统计分析采用泊松广义线性回归模型，采用分布式滞后非线性模型识别滞后和非线性效应，采用收敛交叉映射识别因果关联。

结果

对总人口（n=10,233,519）的分析表明，研究期间有 28,824 例 AE 事件需要急诊入院。昼夜温差在儿科（婴儿、学龄前儿童和学龄儿童）和老年（相对风险 [RR]，分别为 1.056-1.078 和 1.016）人群中具有显著影响。树木和杂草花粉、人类鼻病毒和流感病毒在学龄儿童中具有显著影响（RR，分别为 1.014、1.040、1.042 和 1.038）。树木花粉和流感病毒在成年人群中具有显著影响（RR，分别为 1.026 和 1.044）。户外空气污染物（直径≤10μm 的颗粒物、二氧化氮、臭氧、一氧化碳和二氧化硫）在所有年龄组（婴儿除外的一氧化碳和二氧化硫）中均具有显著的短期影响。