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2013 年野火季节俄勒冈州野火烟雾暴露与哮喘特定医疗保健利用之间的关联。

The association between wildfire smoke exposure and asthma-specific medical care utilization in Oregon during the 2013 wildfire season.

机构信息

Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523, USA.

Department of Atmospheric Science, Colorado State University, Fort Collins, CO, USA.

出版信息

J Expo Sci Environ Epidemiol. 2020 Jul;30(4):618-628. doi: 10.1038/s41370-020-0210-x. Epub 2020 Feb 12.

Abstract

Wildfire smoke (WFS) increases the risk of respiratory hospitalizations. We evaluated the association between WFS and asthma healthcare utilization (AHCU) during the 2013 wildfire season in Oregon. WFS particulate matter ≤ 2.5 μm in diameter (PM) was estimated using a blended model of in situ monitoring, chemical transport models, and satellite-based data. Asthma claims and place of service were identified from Oregon All Payer All Claims data from 1 May 2013 to 30 September 2013. The association with WFS PM was evaluated using time-stratified case-crossover designs. The maximum WFS PM concentration during the study period was 172 µg/m. A 10 µg/m increase in WFS increased risk in asthma diagnosis at emergency departments (odds ratio [OR]: 1.089, 95% confidence interval [CI]: 1.043-1.136), office visit (OR: 1.050, 95% CI: 1.038-1.063), and outpatient visits (OR: 1.065, 95% CI: 1.029-1.103); an association was observed with asthma rescue inhaler medication fills (OR: 1.077, 95% CI: 1.065-1.088). WFS increased the risk for asthma morbidity during the 2013 wildfire season in Oregon. Communities impacted by WFS could see increases in AHCU for tertiary, secondary, and primary care.

摘要

野火烟雾(WFS)增加了呼吸道住院的风险。我们评估了 2013 年俄勒冈野火季节期间 WFS 与哮喘保健利用(AHCU)之间的关联。使用现场监测、化学输送模型和基于卫星的数据的混合模型来估计直径≤2.5μm 的 WFS 颗粒物质(PM)。从 2013 年 5 月 1 日至 2013 年 9 月 30 日,从俄勒冈州所有支付者所有索赔数据中确定哮喘索赔和服务地点。使用时间分层病例交叉设计评估与 WFS PM 的关联。研究期间的最大 WFS PM 浓度为 172μg/m。WFS 增加 10μg/m,急诊部门(比值比 [OR]:1.089,95%置信区间 [CI]:1.043-1.136)、门诊就诊(OR:1.050,95% CI:1.038-1.063)和门诊就诊(OR:1.065,95% CI:1.029-1.103)的哮喘诊断风险增加;观察到哮喘缓解吸入器药物补充(OR:1.077,95% CI:1.065-1.088)与 WFS 之间存在关联。WFS 增加了俄勒冈州 2013 年野火季节哮喘发病率的风险。受 WFS 影响的社区可能会看到三级、二级和初级保健的 AHCU 增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ef1/8745685/81056273feac/nihms-1554469-f0001.jpg

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