Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa.
Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pa.
J Allergy Clin Immunol. 2021 Jul;148(1):225-233. doi: 10.1016/j.jaci.2021.04.011. Epub 2021 Apr 21.
Previous studies have related sulfur dioxide (SO) exposure to asthma exacerbations. We utilized the University of Pittsburgh Asthma Institute registry to study associations of asthma exacerbations between 2 geographically distinct populations of adults with asthma.
Our objective was to examine whether asthma symptoms worsened following a significant fire event that destroyed pollution control equipment at the largest coke works in the United States.
Two groups of patients with asthma, namely, those residing within 10 miles of the coke works fire (the proximal group [n = 39]) and those residing beyond that range (the control group [n = 44]), were geocoded by residential address. Concentrations of ambient air SO were generated by using local University of Pittsburgh Asthma Institute registry air monitoring data. Factory emissions were also evaluated. Data from a patient historical acute exposure survey and in-person follow-up data were evaluated. Inferential statistics were used to compare the groups.
In the immediate postfire period (6-8 weeks), the level of emissions of SO from the factory emissions increased to 25 times more than the typical level. Following the pollution control breach, the proximal cohort self-reported an increase in medication use (risk ratio = 1.76; 95% CI = 1.1-2.8; P < .01) and more exacerbations. In a small subset of the follow-up cohort of those who completed the acute exposure survey only, asthma control metrics improved.
Real-world exposure to a marked increase in ambient levels of SO from a pollution control breach was associated with worsened asthma control in patients proximal to the event, with the worsened control improving following repair of the controls. Improved spatial resolution of air pollutant measurements would enable better examination of exposures and subsequent health impacts.
先前的研究表明，二氧化硫（SO）暴露与哮喘恶化有关。我们利用匹兹堡哮喘研究所的登记处，研究了美国最大焦炭厂的污染控制设备发生重大火灾后，两个地理位置不同的成年哮喘患者群体之间哮喘恶化的关联。
我们的目的是研究在污染控制设备发生重大火灾后，是否会出现哮喘症状恶化的情况，该火灾摧毁了美国最大的焦炭厂的污染控制设备。
通过居住地址对两组哮喘患者进行地理编码，即居住在焦炭厂火灾 10 英里范围内的患者（近端组[n=39]）和居住在该范围以外的患者（对照组[n=44]）。使用当地匹兹堡哮喘研究所登记处的空气监测数据生成环境空气 SO 浓度。还评估了工厂排放。评估了患者历史急性暴露调查和现场随访数据。使用推断统计学比较两组。
在火灾后的 immediate postfire 期间（6-8 周），工厂排放的 SO 排放量增加到典型水平的 25 倍以上。污染控制破裂后，近端队列报告药物使用增加（风险比=1.76；95%置信区间=1.1-2.8；P<0.01）和更多的恶化。在仅完成急性暴露调查的随访队列的一小部分中，哮喘控制指标得到改善。
从污染控制破坏导致的环境中 SO 水平的明显增加中，实际接触到的污染物与事件发生地附近患者的哮喘控制恶化有关，随着控制的修复，恶化的控制得到改善。空气质量污染物测量的空间分辨率的提高将能够更好地检查暴露情况及其随后对健康的影响。
