Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
Department of Geology and Geography, West Virginia University, Morgantown, West Virginia, USA.
Environ Health Perspect. 2022 Aug;130(8):87003. doi: 10.1289/EHP10440. Epub 2022 Aug 3.
Studies of thunderstorm asthma to understand risk factors using high-resolution climate data and asthma outcomes on a large scale are scarce. Moreover, thunderstorm asthma is not well studied in the United States.
We examined whether climate parameters involved in thunderstorms are associated with emergency department (ED) visits for acute asthma attacks in the United States.
We analyzed 63,789 asthma-related, daily ED visits for all age groups, and thunderstorm-associated climate data in Louisiana during 2010 through 2012. We performed time-series analyses using quasi-Poisson regression models with natural cubic splines of date, parish, holiday, day of week, season, daily maximum concentrations of ozone () and fine particulate matter [PM in aerodynamic diameter ()], and daily mean pressure, precipitation, and temperature. Because of a significant interaction effect between temperature and lightning days on asthma-related visits, we performed stratified analyses by days with/without lightning or thunderstorm (defined by any lightning and precipitation).
On thunderstorm days, higher asthma-related ED visits were associated with higher daily mean precipitation [ (95% CI: 1.009, 1.300)] and lower daily mean temperature [ per 1°C change (1.000-1.021)] without carry-over effect to the next non-thunderstorm day. These higher risks were found mainly among children and adults of age. We observed similar results on lightning days. However, we did not find similar associations for non-thunderstorm or non-lightning days. Daily maximum and levels were not significantly associated with asthma ED visits on thunderstorm days.
Higher precipitation and lower temperature on thunderstorm days appear to contribute to asthma attacks among people with asthma, suggesting they should consider taking precautions during thunderstorms. EDs should consider preparing for a potential increase of asthma-related visits and ensuring sufficient stock of emergency medication and supplies for forecasted severe thunderstorm days. https://doi.org/10.1289/EHP10440.
利用高分辨率气候数据和大规模哮喘结果研究雷暴哮喘的危险因素的研究很少。此外，雷暴哮喘在美国研究得还不够充分。
我们研究了雷暴中涉及的气候参数是否与美国急诊室（ED）因急性哮喘发作而就诊有关。
我们分析了 2010 年至 2012 年期间路易斯安那州所有年龄段的 63789 例哮喘相关的每日 ED 就诊情况和与雷暴相关的气候数据。我们使用具有日期、教区、节假日、星期几、季节、臭氧（O3）和细颗粒物[空气动力学直径（PM2.5）]每日最大浓度以及每日平均气压、降水和温度的自然三次样条的拟泊松回归模型进行时间序列分析。由于温度和闪电日对哮喘相关就诊的交互效应显著，我们按有/无闪电或雷暴（由任何闪电和降水定义）的日进行分层分析。
在雷暴日，较高的哮喘相关 ED 就诊与较高的每日平均降水量[（95%CI：1.009，1.300）]和较低的每日平均温度[每 1°C 变化（1.000-1.021）]相关，对下一个非雷暴日没有滞后效应。这些较高的风险主要发生在儿童和年龄为 65 岁及以上的成年人中。我们在闪电日也观察到了类似的结果。然而，我们在非雷暴日或非闪电日并未发现类似的关联。在雷暴日，每日最大 O3 和 PM2.5 水平与哮喘 ED 就诊无显著相关性。
雷暴日较高的降水量和较低的温度似乎会导致哮喘患者哮喘发作，这表明他们在雷暴期间应考虑采取预防措施。ED 应考虑为可能因预测的严重雷暴日而增加的哮喘相关就诊做好准备，并确保有足够的储备应急药物和供应品。https://doi.org/10.1289/EHP10440.
