Rublee C S, Sorensen C J, Lemery J, Wade T J, Sams E A, Hilborn E D, Crooks J L
Department of Emergency Medicine University of Colorado School of Medicine Aurora CO USA.
United States Environmental Protection Agency Chapel Hill NC USA.
Geohealth. 2020 Aug 1;4(8):e2020GH000260. doi: 10.1029/2020GH000260. eCollection 2020 Aug.
Anthropogenic climate change is influencing the incidence of dust storms and associated human exposure to coarse particulate matter (PM) in the United States. Studies have found adverse health consequences related to dust exposure. These consequences include respiratory disease exacerbations and premature mortality, resulting in increased health care utilization. However, the impact of dust storms on critical care demand has not been studied in the United States. We seek to quantify the relationship between dust storms and surges in critical care demand by investigating the association between dust storms and intensive care unit (ICU) admissions at nearby hospitals from 2000 to 2015. ICU data were acquired from Premier, Inc. and encompass 15-20% of all ICU admissions in the United States. Dust storm, meteorology, and air pollutant data were downloaded from the U.S. National Weather Service, the U.S. National Climatic Data Center, and the U.S. Environmental Protection Agency websites, respectively. Associations between ICU admission and dust storms, controlling for temperature, dew point temperature, ambient PM and ozone, as well as seasonally varying confounders, were estimated using a distributed lag conditional Poisson model with overdispersion. We found a 4.8% (95% CI: 0.4, 9.4; = 0.033) increase in total ICU admissions on the day of the dust storm (Lag 0) and a 9.2% (95% CI: 1.8, 17.0; = 0.013) and 7.5% (95% CI: 0.3, 15.2; = 0.040) increase in respiratory admissions at Lags 0 and 5. North American dust storms are associated with increases in same day and lagged demand for critical care services at nearby hospitals.
人为气候变化正在影响美国沙尘暴的发生率以及人类接触粗颗粒物(PM)的情况。研究发现,沙尘暴露会对健康产生不良影响。这些影响包括呼吸道疾病加重和过早死亡,从而导致医疗保健利用率增加。然而,在美国尚未对沙尘暴对重症监护需求的影响进行研究。我们试图通过调查2000年至2015年沙尘暴与附近医院重症监护病房(ICU)入院之间的关联,来量化沙尘暴与重症监护需求激增之间的关系。ICU数据来自Premier公司,涵盖美国所有ICU入院病例的15%-20%。沙尘暴、气象和空气污染物数据分别从美国国家气象局、美国国家气候数据中心和美国环境保护局网站下载。使用具有过度分散的分布滞后条件泊松模型,估计了ICU入院与沙尘暴之间的关联,并对温度、露点温度、环境PM和臭氧以及季节性变化的混杂因素进行了控制。我们发现,在沙尘暴当天(滞后0天),ICU入院总数增加了4.8%(95%置信区间:0.4,9.4;P=0.033),在滞后0天和5天,呼吸道疾病入院人数分别增加了9.2%(95%置信区间:1.8,17.0;P=0.013)和7.5%(95%置信区间:0.3,15.2;P=0.040)。北美沙尘暴与附近医院当日及滞后的重症监护服务需求增加有关。