School of Biomedical Sciences, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Biomedical Sciences, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Environ Res. 2020 Mar;182:109125. doi: 10.1016/j.envres.2020.109125. Epub 2020 Jan 8.
It is unknown if high concentration of airborne grass pollen, where subtropical grasses (Chloridoideae and Panicoideae) dominate, is a risk factor for respiratory health. Here we systematically reviewed the association between airborne grass pollen exposure and asthma emergency department (ED) presentations and hospital admissions in subtropical climates.
A systematic review was performed to identify and summarise studies that reported on respiratory health (asthma ED presentations and hospital admissions) and airborne grass pollen exposure in subtropical climates.
Searches were conducted in: MEDLINE, Web of Science, Scopus, CINAHL (EBSCO), Embase and Google Scholar databases (1966-2019). Risk of bias was assessed using a validated quality assessment tool. A meta-analysis was planned, however due to the heterogeneity in study design it was determined inappropriate and instead a narrative synthesis was undertaken.
Nineteen studies were identified for inclusion, with a total of 598,931 asthma ED presentation participants and 36,504 asthma hospital admission participants in six countries (Australia, India, Israel, Italy, Spain, USA). The narrative synthesis found airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations (judged as: probably little effect n = 5, may have little effect n = 4, no effect n = 2 and uncertain if there is an effect n = 4) and hospital admissions (judged as: probably increase slightly n = 2 probably little effect n = 1, may have a little effect n = 1, no effect n = 3 and we are uncertain if there is an effect n = 4) in the subtropics. Furthermore, the reported effect sizes were small and its clinical relevance may be difficult to discern.
Exposure to airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations and hospital admissions in the subtropics. These findings are comparable to reported observations from studies undertaken in temperate regions.
目前尚不清楚空气中高浓度的草花粉（以亚热带草类（Chloridoideae 和 Panicoideae）为主）是否是呼吸道健康的危险因素。在这里，我们系统地回顾了亚热带气候下空气中草花粉暴露与哮喘急诊就诊和住院之间的关系。
进行系统评价，以确定和总结报告呼吸道健康（哮喘急诊就诊和住院）和亚热带空气中草花粉暴露的研究。
在 MEDLINE、Web of Science、Scopus、CINAHL（EBSCO）、Embase 和 Google Scholar 数据库中进行了检索（1966-2019 年）。使用经过验证的质量评估工具评估偏倚风险。由于研究设计存在异质性，计划进行荟萃分析，但结果表明不适合，因此进行了叙述性综合分析。
确定了 19 项纳入研究，共有来自六个国家（澳大利亚、印度、以色列、意大利、西班牙和美国）的 598931 名哮喘急诊就诊参与者和 36504 名哮喘住院参与者。叙述性综合分析发现，空气中草花粉似乎对哮喘急诊就诊（判断为：可能影响较小 n=5，可能影响较小 n=4，无影响 n=2，不确定是否有影响 n=4）和住院（判断为：可能略有增加 n=2，可能影响较小 n=1，可能影响较小 n=1，无影响 n=3，不确定是否有影响 n=4）有小而不一致的影响。此外，报告的效应大小较小，其临床相关性可能难以确定。
空气中草花粉的暴露似乎对亚热带地区的哮喘急诊就诊和住院有较小且不一致的增加。这些发现与在温带地区进行的研究报告的观察结果相当。
