Deng Shizhou, Han Azhu, Jin Shuyan, Wang Shuang, Zheng Jing, Jalaludin Bin B, Hajat Shakoor, Liang Wannian, Huang Cunrui
School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration & Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
School of Public Health, Sun Yat-sen University, Guangzhou, China.
Environ Res. 2023 Jun 1;226:115679. doi: 10.1016/j.envres.2023.115679. Epub 2023 Mar 11.
Although ambient temperature has been linked to asthma exacerbation, impacts associated with extreme temperature events remain unclear. This study aims to identify the events characteristics that elevate risk of asthma hospital visits, and to assess whether healthy behavior changes due to the COVID-19 prevention and control policy may modify the relationships. Data of asthma hospital visits from all medical facilities in Shenzhen, China during 2016-2020 were assessed in relation to extreme temperature events using a distributed lag model. Stratified analysis was conducted by gender, age and hospital department to identify susceptible populations. Through events defined by various duration days and temperature thresholds, we explored the modification by events intensity, length, occurrence time and healthy behaviors. The cumulative relative risk of asthma during heat waves compared to other days was 1.06 (95%CI: 1.00-1.13) and for cold spells was 1.17 (95%CI: 1.05-1.30), and that of males and school-aged children were generally higher than other sub-groups. There were significant effects of heat waves and cold spells on asthma hospital visits when the mean temperature was above 90th percentile (30 °C) and below 10th percentile (14 °C) respectively, and the relative risks were higher when events lasted longer, became stronger, occurred in daytime and in early summer or winter. During the healthy behaviors maintaining period, the risk of heat waves increased whilst the risk of cold spells reduced. Extreme temperatures may pose considerable impact on asthma and the health effect can be modified by the event characteristics and anti-epidemic healthy behaviors. Strategies of asthma control should consider the heightened threats of the intense and frequent extreme temperature events in the context of climate change.
尽管环境温度与哮喘发作有关，但极端温度事件的相关影响仍不明确。本研究旨在确定会增加哮喘住院风险的事件特征，并评估由于新冠疫情防控政策导致的健康行为变化是否会改变这种关系。利用分布滞后模型，评估了2016年至2020年期间中国深圳所有医疗机构的哮喘住院数据与极端温度事件的关系。按性别、年龄和医院科室进行分层分析，以确定易感人群。通过由不同持续天数和温度阈值定义的事件，我们探讨了事件强度、持续时间、发生时间和健康行为的影响。与其他日子相比，热浪期间哮喘的累积相对风险为1.06（95%CI：1.00 - 1.13），寒潮期间为1.17（95%CI：1.05 - 1.30），男性和学龄儿童的累积相对风险通常高于其他亚组。当平均温度分别高于第90百分位数（30℃）和低于第10百分位数（14℃）时，热浪和寒潮对哮喘住院有显著影响，且当事件持续时间更长、强度更大、发生在白天以及初夏或冬季时，相对风险更高。在保持健康行为期间，热浪风险增加，而寒潮风险降低。极端温度可能对哮喘造成相当大的影响，且健康影响可因事件特征和抗疫健康行为而改变。哮喘控制策略应考虑在气候变化背景下，强烈且频繁的极端温度事件带来的更大威胁。
