Anenberg Susan C, Weinberger Kate R, Roman Henry, Neumann James E, Crimmins Allison, Fann Neal, Martinich Jeremy, Kinney Patrick L
Environmental Health Analytics, LLC Washington District of Columbia USA.
Institute at Brown for Environment & Society Brown University Providence Rhode Island USA.
Geohealth. 2017 May 3;1(3):80-92. doi: 10.1002/2017GH000055. eCollection 2017 May.
Future climate change is expected to lengthen and intensify pollen seasons in the U.S., potentially increasing incidence of allergic asthma. We developed a proof-of-concept approach for estimating asthma emergency department (ED) visits in the U.S. associated with present-day and climate-induced changes in oak pollen. We estimated oak pollen season length for moderate (Representative Concentration Pathway (RCP) 4.5) and severe climate change scenarios (RCP8.5) through 2090 using five climate models and published relationships between temperature, precipitation, and oak pollen season length. We calculated asthma ED visit counts associated with 1994-2010 average oak pollen concentrations and simulated future oak pollen season length changes using the Environmental Benefits Mapping and Analysis Program, driven by epidemiologically derived concentration-response relationships. Oak pollen was associated with 21,200 (95% confidence interval, 10,000-35,200) asthma ED visits in the Northeast, Southeast, and Midwest U.S. in 2010, with damages valued at $10.4 million. Nearly 70% of these occurred among children age <18 years. Severe climate change could increase oak pollen season length and associated asthma ED visits by 5% and 10% on average in 2050 and 2090, with a marginal net present value through 2090 of $10.4 million (additional to the baseline value of $346.2 million). Moderate versus severe climate change could avoid >50% of the additional oak pollen-related asthma ED visits in 2090. Despite several key uncertainties and limitations, these results suggest that aeroallergens pose a substantial U.S. public health burden, that climate change could increase U.S. allergic disease incidence, and that mitigating climate change may have benefits from avoided pollen-related health impacts.
预计未来气候变化将延长并加剧美国的花粉季节，可能会增加过敏性哮喘的发病率。我们开发了一种概念验证方法，用于估算美国因当前和气候导致的橡树花粉变化而引发的哮喘急诊就诊情况。我们使用五个气候模型，并依据已发表的温度、降水与橡树花粉季节长度之间的关系，估算了到2090年中等（代表性浓度路径（RCP）4.5）和严重气候变化情景（RCP8.5）下的橡树花粉季节长度。我们根据1994 - 2010年橡树花粉平均浓度计算了哮喘急诊就诊次数，并利用环境效益映射与分析程序模拟了未来橡树花粉季节长度的变化，该程序由流行病学得出的浓度 - 反应关系驱动。2010年，美国东北部、东南部和中西部地区有21200例（95%置信区间为10000 - 35200例）哮喘急诊就诊与橡树花粉有关，造成的损失达1040万美元。其中近70%发生在18岁以下儿童中。到2050年和2090年，严重气候变化可能会使橡树花粉季节长度和相关哮喘急诊就诊次数平均分别增加5%和10%，到2090年的边际净现值为1040万美元（在3.462亿美元的基线值基础上增加）。与严重气候变化相比，中等气候变化到2090年可避免超过50%的额外与橡树花粉相关的哮喘急诊就诊。尽管存在一些关键的不确定性和局限性，但这些结果表明，气传变应原给美国公众健康带来了沉重负担，气候变化可能会增加美国过敏性疾病的发病率，而缓解气候变化可能会因避免与花粉相关的健康影响而带来益处。
