Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA.
Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX 77030, USA.
Int J Environ Res Public Health. 2020 Jul 6;17(13):4846. doi: 10.3390/ijerph17134846.
Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities. This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas. A time-stratified case-crossover study was conducted using the hospitalization data from a children's hospital and the air pollution data, including particulate matter 2.5 (PM) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014. A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature. We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014. The single-pollutant models showed that PM concentration had a significant positive effect on risk for hospital readmissions (OR = 1.082, 95% CI = 1.008-1.162, = 0.030). In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1.023, 95% CI = 1.001-1.045, = 0.042) and PM concentrations (OR = 1.080, 95% CI = 1.005-1.161, = 0.036). The effects of ambient air pollutants on hospital readmissions varied by age and season. Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients.
很少有研究评估环境空气污染与哮喘儿童住院再入院之间的关系，特别是在低收入社区。本研究调查了环境空气污染物对南德克萨斯州儿科哮喘住院再入院的短期影响。使用儿童医院的住院数据和疾病控制与预防中心的空气污染数据（包括 2.5 颗粒物和臭氧浓度），进行了时间分层病例交叉研究，研究时间为 2010 年至 2014 年。采用条件逻辑回归分析，控制室外温度，调查环境空气污染与住院再入院之间的关联。我们确定了 2010 年至 2014 年期间 111 名儿科哮喘患者住院再入院。单污染物模型表明，PM 浓度对住院再入院风险有显著的正向影响（OR=1.082，95%CI=1.008-1.162，p=0.030）。在双污染物模型中，臭氧（OR=1.023，95%CI=1.001-1.045，p=0.042）和 PM 浓度（OR=1.080，95%CI=1.005-1.161，p=0.036）升高与儿科哮喘再入院风险增加显著相关。环境空气污染物对住院再入院的影响因年龄和季节而异。我们的研究结果表明，短期（4 天）暴露于空气污染物可能会增加儿科哮喘患者可预防住院再入院的风险。
