Smith M Luke, MacLehose Richard F, Chandler John W, Berman Jesse D
From the Minnesota Population Center, University of Minnesota School of Public Health, Minneapolis, MN.
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
Epidemiology. 2022 Sep 1;33(5):624-632. doi: 10.1097/EDE.0000000000001506. Epub 2022 May 16.
Previous research has shown an association between individual thunderstorm events in the presence of high pollen, commonly called thunderstorm asthma, and acute severe asthma events, but little work has studied risk over long periods of time, using detailed measurements of storms and pollen.
We estimated change in the risk of asthma-related emergency room visits related to thunderstorm asthma events in the Minneapolis-St. Paul metropolitan area over the years 2007-2018. We defined thunderstorm asthma events as daily occurrence of two or more lightning strikes during high pollen periods interpolating weather and pollen monitor data and modeling lightning counts. We acquired daily counts of asthma-related emergency department visits from the Minnesota Hospital Association and used a quasi-Poisson time-series regression to estimate overall relative risk of emergency department visits during thunderstorm asthma events.
We observed a 1.047 times higher risk (95% confidence interval = 1.012, 1.083) of asthma-related emergency department visits on the day of thunderstorm asthma event. Our findings are robust to adjustment for temperature, humidity, wind, precipitation, ozone, PM 2.5 , day of week, and seasonal variation in asthma cases. Occurrence of lightning alone or pollen alone showed no association with the risk of severe asthma. A two-stage analysis combining individual zip code-level results shows similar RR, and we see no evidence of spatial correlation or spatial heterogeneity of effect.
Our results support an association between co-occurrence of lightning and pollen and risk of severe asthma events. Our approach incorporates lightning and pollen data and small-spatial area exposure and outcome counts.
先前的研究表明，在高花粉浓度情况下出现的个别雷暴事件（通常称为雷暴哮喘）与急性重症哮喘事件之间存在关联，但很少有研究使用详细的风暴和花粉测量数据来长期研究风险。
我们估计了2007年至2018年明尼阿波利斯 - 圣保罗大都市地区与雷暴哮喘事件相关的哮喘相关急诊就诊风险的变化。我们将雷暴哮喘事件定义为在高花粉期每日发生两次或更多次雷击，通过插值天气和花粉监测数据并对闪电计数进行建模。我们从明尼苏达医院协会获取了哮喘相关急诊科就诊的每日计数，并使用准泊松时间序列回归来估计雷暴哮喘事件期间急诊科就诊的总体相对风险。
我们观察到在雷暴哮喘事件当天，哮喘相关急诊科就诊风险高出1.047倍（95%置信区间 = 1.012, 1.083）。我们的研究结果在对温度、湿度、风、降水、臭氧、PM 2.5、星期几以及哮喘病例的季节变化进行调整后依然稳健。单独出现闪电或单独出现花粉与重症哮喘风险均无关联。结合各个邮政编码区域层面结果的两阶段分析显示了相似的相对风险，并且我们没有发现空间相关性或效应的空间异质性的证据。
我们的结果支持闪电和花粉同时出现与重症哮喘事件风险之间存在关联。我们的方法纳入了闪电和花粉数据以及小空间区域暴露和结果计数。
