Schinasi Leah H, Kenyon Chen C, Hubbard Rebecca A, Zhao Yuzhe, Maltenfort Mitchell, Melly Steven J, Moore Kari, Forrest Christopher B, Diez Roux Ana V, de Roos Anneclaire J
Department of Environmental and Occupational Health, Dornsife School of Public Health at Drexel University, Philadelphia, Pennsylvania, USA
Urban Health Collaborative, Dornsife School of Public Health at Drexel University, Philadelphia, Pennsylvania, USA.
Occup Environ Med. 2022 May;79(5):326-332. doi: 10.1136/oemed-2021-107823. Epub 2022 Mar 4.
High ambient temperatures may contribute to acute asthma exacerbation, a leading cause of morbidity in children. We quantified associations between hot-season ambient temperatures and asthma exacerbation in children ages 0-18 years in Philadelphia, PA.
We created a time series of daily counts of clinical encounters for asthma exacerbation at the Children's Hospital of Philadelphia linked with daily meteorological data, June-August of 2011-2016. We estimated associations between mean daily temperature (up to a 5-day lag) and asthma exacerbation using generalised quasi-Poisson distributed models, adjusted for seasonal and long-term trends, day of the week, mean relative humidity,and US holiday. In secondary analyses, we ran models with adjustment for aeroallergens, air pollutants and respiratory virus counts. We quantified overall associations, and estimates stratified by encounter location (outpatient, emergency department, inpatient), sociodemographics and comorbidities.
The analysis included 7637 asthma exacerbation events. High mean daily temperatures that occurred 5 days before the index date were associated with higher rates of exacerbation (rate ratio (RR) comparing 33°C-13.1°C days: 1.37, 95% CI 1.04 to 1.82). Associations were most substantial for children ages 2 to <5 years and for Hispanic and non-Hispanic black children. Adjustment for air pollutants, aeroallergens and respiratory virus counts did not substantially change RR estimates.
This research contributes to evidence that ambient heat is associated with higher rates of asthma exacerbation in children. Further work is needed to explore the mechanisms underlying these associations.
环境温度过高可能会导致急性哮喘发作，这是儿童发病的主要原因。我们对宾夕法尼亚州费城0至18岁儿童在炎热季节的环境温度与哮喘发作之间的关联进行了量化。
我们创建了一个时间序列，将2011年至2016年6月至8月期间费城儿童医院哮喘发作的临床就诊每日计数与每日气象数据相关联。我们使用广义拟泊松分布模型估计平均每日温度（最长滞后5天）与哮喘发作之间的关联，并对季节和长期趋势、星期几、平均相对湿度和美国节假日进行了调整。在二次分析中，我们运行了对空气过敏原、空气污染物和呼吸道病毒计数进行调整的模型。我们对总体关联以及按就诊地点（门诊、急诊科、住院部）、社会人口统计学和合并症分层的估计进行了量化。
分析包括7637例哮喘发作事件。指数日期前5天出现的高平均每日温度与更高的发作率相关（比较33°C - 13.1°C天数的率比（RR）：1.37，95%置信区间1.04至1.82）。对于2至<5岁的儿童以及西班牙裔和非西班牙裔黑人儿童，关联最为显著。对空气污染物、空气过敏原和呼吸道病毒计数的调整并没有实质性改变RR估计值。
这项研究为环境热与儿童哮喘发作率较高相关的证据提供了补充。需要进一步开展工作来探索这些关联背后的机制。
