Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus.
Medical School, University of Crete, Heraklion, Crete, Greece.
Sci Total Environ. 2023 Feb 20;860:160518. doi: 10.1016/j.scitotenv.2022.160518. Epub 2022 Nov 26.
Current public health recommendations for desert dust storms (DDS) events focus on vulnerable population groups, such as children with asthma, and include advice to stay indoors and limit outdoor physical activity. To date, no scientific evidence exists on the efficacy of these recommendations in reducing DDS exposure. We aimed to objectively assess the behavioral responses of children with asthma to recommendations for reduction of DDS exposure. In two heavily affected by DDS Mediterranean regions (Cyprus & Crete, Greece), schoolchildren with asthma (6-11 years) were recruited from primary schools and were randomized to control (business as usual scenario) and intervention groups. All children were equipped with pedometer and GPS sensors embedded in smartwatches for objective real-time data collection from inside and outside their classroom and household settings. Interventions included the timely communication of personal DDS alerts accompanied by exposure reduction recommendations to both the parents and school-teachers of children in the intervention group. A mixed effect model was used to assess changes in daily levels of time spent, and steps performed outside classrooms and households, between non-DDS and DDS days across the study groups. The change in the time spent outside classrooms and homes, between non-DDS and DDS days, was 37.2 min (p = 0.098) in the control group and -62.4 min (p < 0.001) in the intervention group. The difference in the effects between the two groups was statistically significant (interaction p < 0.001). The change in daily steps performed outside classrooms and homes, was -495.1 steps (p = 0.350) in the control group and -1039.5 (p = 0.003) in the intervention group (interaction p = 0.575). The effects on both the time and steps performed outside were more profound during after-school hours. To summarize, among children with asthma, we demonstrated that timely personal DDS alerts and detailed recommendations lead to significant behavioral changes in contrast to the usual public health recommendations.
目前针对沙尘暴（DDS）事件的公共卫生建议主要关注弱势群体，如患有哮喘的儿童，并建议他们待在室内，限制户外活动。迄今为止，尚无科学证据表明这些建议在减少 DDS 暴露方面的效果。我们旨在客观评估哮喘儿童对减少 DDS 暴露建议的行为反应。在两个受 DDS 影响严重的地中海地区（塞浦路斯和克里特岛，希腊），我们从小学招募了哮喘儿童（6-11 岁），并将他们随机分为对照组（照常进行）和干预组。所有儿童都配备了计步器和 GPS 传感器，嵌入智能手表中，以从教室和家庭内外实时收集客观数据。干预措施包括及时向儿童家长和教师发送个人 DDS 警报，并提供减少暴露的建议。使用混合效应模型评估研究组中非 DDS 日和 DDS 日之间，教室和家庭外的日常时间和步数的变化。与非 DDS 日相比，对照组的教室和家庭外的时间花费增加了 37.2 分钟（p = 0.098），而干预组则减少了 62.4 分钟（p < 0.001）。两组之间的效果差异具有统计学意义（交互作用 p < 0.001）。与对照组相比，教室和家庭外的日常步数减少了 495.1 步（p = 0.350），而干预组则减少了 1039.5 步（p = 0.003）（交互作用 p = 0.575）。在课外时间，这两种效果更为明显。总之，对于哮喘儿童，我们证明，及时的个人 DDS 警报和详细的建议会导致行为发生显著变化，这与通常的公共卫生建议形成对比。
