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在亚热带环境下,气象变化、室外空气污染与儿童急性细支气管炎的短期关联。

Short-term association among meteorological variation, outdoor air pollution and acute bronchiolitis in children in a subtropical setting.

机构信息

Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China.

School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Thorax. 2021 Apr;76(4):360-369. doi: 10.1136/thoraxjnl-2020-215488. Epub 2021 Jan 20.

Abstract

OBJECTIVES

To examine the association among acute bronchiolitis-related hospitalisation in children, meteorological variation and outdoor air pollution.

METHODS

We obtained the daily counts of acute bronchiolitis-related admission of children≤2 years old from all public hospitals, meteorological data and outdoor air pollutants' concentrations between 1 January 2008 and 31 December 2017 in Hong Kong. We used quasi-Poisson generalised additive models together with distributed lag non-linear models to estimate the associations of interest adjusted for confounders.

RESULTS

A total of 29 688 admissions were included in the analysis. Increased adjusted relative risk (ARR) of acute bronchiolitis-related hospitalisation was associated with high temperature (ambient temperature and apparent temperature) and was marginally associated with high vapour pressure, a proxy for absolute humidity. High concentration of NO was associated with elevated risk of acute bronchiolitis admission; the risk of bronchiolitis hospitalisation increased statistically significantly with cumulative NO exposure over the range 66.2-119.6 µg/m. For PM, the significant effect observed at high concentrations appears to be immediate but not long lasting. For SO, ARR increased as the concentration approached the 75th percentile and then decreased though the association was insignificant.

CONCLUSIONS

Acute bronchiolitis-related hospitalisation among children was associated with temperature and exposure to NO and PM at different lag times, suggesting a need to adopt sustainable clean air policies, especially to target pollutants produced by motor vehicles, to protect young children's health.

摘要

目的

探讨儿童毛细支气管炎相关住院与气象变化和室外空气污染之间的关系。

方法

我们获取了 2008 年 1 月 1 日至 2017 年 12 月 31 日期间香港所有公立医院儿童(≤2 岁)毛细支气管炎相关住院的每日病例数,以及气象数据和室外空气污染物浓度。我们使用拟泊松广义相加模型和分布式滞后非线性模型,在调整混杂因素后,估计相关关联。

结果

共纳入 29688 例住院病例。与急性毛细支气管炎相关的住院调整后相对风险(ARR)与高温(环境温度和表观温度)相关,与高蒸汽压(绝对湿度的代表)呈边缘相关。高浓度的 NO 与急性毛细支气管炎入院风险升高相关;NO 暴露量在 66.2-119.6μg/m 的范围内累积时,支气管肺炎住院的风险显著升高。对于 PM,在高浓度下观察到的显著影响似乎是即时的,但不是持久的。对于 SO,随着浓度接近第 75 百分位数,ARR 增加,然后降低,但相关性不显著。

结论

儿童毛细支气管炎相关住院与不同滞后时间的温度和 NO 及 PM 暴露有关,这表明需要采取可持续的清洁空气政策,特别是针对机动车产生的污染物,以保护幼儿健康。

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