Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China.
The Second People's Hospital of Hefei, Hefei, Anhui 230011, China.
Sci Total Environ. 2020 Jul 1;724:138206. doi: 10.1016/j.scitotenv.2020.138206. Epub 2020 Mar 25.
The present study aimed to understand the effect of diurnal temperature range (DTR) on childhood asthma in Hefei, China, and to explore the effect of temperature on the DTR-asthma association.
Daily data on hospital admissions for childhood asthma, air pollutants, and weather variables in Hefei, China, from 1st January 2014 to 31st December 2015, were collected. A generalized additive model combined with a distributed lag non-linear model was used to quantify the effects of DTR on the total, age- and gender-specific hospital admissions for childhood asthma. A non-parametric bivariate response surface model, and a generalized additive model combined with a stratified parametric model were used to explore the interaction between DTR and temperature.
We observed that high DTR was associated with an increase in hospital admissions for childhood asthma. When DTR increased from 6.7 °C to 16.8 °C (99% percentile), hospital admissions for childhood asthma increased by 13% (relative risk: 1.13, 95% confidence interval: 1.07, 1.12). The analysis stratified, by mean temperature level, suggested that when DTR increased by 1 °C at low temperatures, asthma hospitalizations in total children, girls, boys and school-age children increased by 5.0% (95% CI: 2.6%, 7.5%), 3.7% (95% CI: 0.4%, 5.7%), 2.9% (95% CI: 0.8%, 4.4%) and 5.0% (95% CI: 2.6%, 7.5%), respectively.
This study suggests that the impact of high DTR should be considered among public health advice for children with existing asthma. Those days with high DTR and low mean temperature need extra attention.
本研究旨在探讨中国合肥昼夜温差（DTR）对儿童哮喘的影响，并探讨温度对 DTR-哮喘关联的影响。
收集了 2014 年 1 月 1 日至 2015 年 12 月 31 日期间中国合肥儿童哮喘住院、空气污染物和天气变量的每日数据。采用广义加性模型结合分布式滞后非线性模型，定量评估 DTR 对儿童哮喘总住院、年龄和性别特异性住院的影响。采用非参数二元响应面模型和广义加性模型结合分层参数模型，探讨 DTR 和温度之间的相互作用。
我们发现，高 DTR 与儿童哮喘住院人数增加有关。当 DTR 从 6.7°C 增加到 16.8°C（99%分位数）时，儿童哮喘住院人数增加了 13%（相对风险：1.13，95%置信区间：1.07，1.12）。按平均温度水平分层分析表明，当 DTR 在低温时增加 1°C 时，总儿童、女孩、男孩和学龄儿童的哮喘住院人数分别增加 5.0%（95%CI：2.6%，7.5%）、3.7%（95%CI：0.4%，5.7%）、2.9%（95%CI：0.8%，4.4%）和 5.0%（95%CI：2.6%，7.5%）。
本研究表明，在为现有哮喘儿童提供公共卫生建议时，应考虑高 DTR 的影响。那些昼夜温差大且平均温度低的日子需要特别关注。
