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暴露于 2010 年艾雅法拉火山喷发人群中的药物使用情况:一项中断时间序列分析。

Medication use in populations exposed to the 2010 Eyjafjallajökull eruption: an interrupted time series analysis.

机构信息

Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland

Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.

出版信息

BMJ Open. 2022 May 9;12(5):e059375. doi: 10.1136/bmjopen-2021-059375.

Abstract

OBJECTIVES

To assess the trends in medication use indicative of physical and psychological morbidity following the 2010 volcanic eruption in Eyjafjallajökull immediately after and during a 3-year period following the eruption.

DESIGN

Population-based register study.

SETTING

Eyjafjallajökull eruption in Iceland, 2007-2013.

PARTICIPANTS

All residents in Iceland who received at least one medication dispensing were identified. Residents of exposed areas were classified into exposure groups (individual-level data) and residents in other parts of Iceland were included as a non-exposed group (aggregated data).

INTERVENTION/EXPOSURE: Eyjafjallajökull erupted on 14 April 2010 and continued for 39 days, producing heavy ash fall in South Iceland.

MAIN OUTCOME MEASURES

Using interrupted time series analysis, we examined annual and quarterly changes in medicine use, measured as number of dispensed defined daily dose (DDD) per 1000 individuals. We calculated the level shift (immediate change) and change in slope from pre-eruption to post-eruption (long-term change) in medication dispensing.

RESULTS

Among exposed residents, there was a 6% decrease (95% CI -7% to -4%) in the annual number of dispensed DDDs 1-year post-eruption in the overall medication class, including analgesics (-5%, 95% CI -6% to -3%), hypnotics and sedatives (-9%, 95% CI -11% to -7%) and respiratory medications (-7%, 95% CI -9% to -5%; -8%, 95% CI -11% to -4%). Simultaneously, there was a 9% decrease (95% CI -14% to -4%) in the overall medication class among non-exposed residents. Moreover, among exposed residents, we observed change in slope of -4% (95% CI -7% to -1%) in the overall medication class, including for analgesics (-6%, 95% CI -8% to -3%) and other respiratory drugs (-10%, 95% CI -16% to -4%).

CONCLUSION

Our findings indicate that the eruption did not lead to increases in medication dispensing among residents of exposed areas, rather decreases for some medicine classes. The results should be interpreted with caution since the content of each eruption differs.

摘要

目的

评估 2010 年冰岛艾雅法拉火山喷发后立即及喷发后 3 年期间,与身体和心理病态相关的药物使用趋势。

设计

基于人群的登记研究。

地点

冰岛艾雅法拉火山喷发,2007-2013 年。

参与者

确定了至少接受一种药物配给的所有冰岛居民。将暴露地区的居民分为暴露组(个体水平数据),并将冰岛其他地区的居民纳入非暴露组(汇总数据)。

干预/暴露:艾雅法拉火山于 2010 年 4 月 14 日爆发,持续了 39 天,在冰岛南部产生了大量的火山灰。

主要观察指标

使用中断时间序列分析,我们检查了药物使用的年度和季度变化,以每 1000 人配给的定义日剂量(DDD)数量衡量。我们计算了喷发后(长期变化)药物配给的水平转移(即立即变化)和斜率变化。

结果

在暴露居民中,总体药物类别(包括镇痛药(-5%,95%CI-6%至-3%)、催眠药和镇静剂(-9%,95%CI-11%至-7%)和呼吸药物(-7%,95%CI-9%至-5%))的年度 DDD 配给数量在喷发后 1 年减少了 6%(95%CI-7%至-4%)。同时,非暴露居民的总体药物类别减少了 9%(95%CI-14%至-4%)。此外,在暴露居民中,我们观察到总体药物类别的斜率变化为-4%(95%CI-7%至-1%),包括镇痛药(-6%,95%CI-8%至-3%)和其他呼吸药物(-10%,95%CI-16%至-4%)。

结论

我们的发现表明,喷发并未导致暴露地区居民的药物配给增加,反而减少了一些药物类别。由于每次喷发的内容不同,因此结果应谨慎解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b128/9086619/8438d12a1e40/bmjopen-2021-059375f01.jpg

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