Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Environ Int. 2023 Jul;177:107998. doi: 10.1016/j.envint.2023.107998. Epub 2023 Jun 3.
Compared to many environmental risk factors, the relationship between pollen and asthma is understudied, including how associations may differ by pollen type and between subgroups, and how associations may be changing over time.
We evaluated the association between ambient pollen concentrations and emergency department (ED) visits for asthma and wheeze in Atlanta, Georgia during 1993-2018. We estimated overall associations for 13 individual pollen taxa, as well as associations by decade, race, age (5-17, 18-64, 65+), and insurance status (Medicaid vs non-Medicaid).
Speciated pollen data were acquired from Atlanta Allergy & Asthma, a nationally certified pollen counting station. ED visit data were obtained from individual hospitals and from the Georgia Hospital Association. We performed time-series analyses using quasi-Poisson distributed lag models, with primary analyses assessing 3-day (lag 0-2 days) pollen levels. Models controlled for day of week, holidays, air temperature, month, year, and month-by-year interactions.
From 1993 to 2018, there were 686,259 ED visits for asthma and wheeze in the dataset, and the number of ED visits increased over time. We observed positive associations of asthma and wheeze ED visits with nine of the 13 pollen taxa: trees (maple, birch, pine, oak, willow, sycamore, and mulberry), two weeds (nettle and pigweed), and grasses. Rate ratios indicated 1-8% increases in asthma and wheeze ED visits per standard deviation increases in pollen. In general, we observed stronger associations in the earliest period (1993-2000), in younger people, and in Black patients; however, results varied by pollen taxa.
Some, but not all, types of pollen are associated with increased ED visits for asthma/wheeze. Associations are generally higher in Black and younger patients and appear to have decreased over time.
相较于许多环境风险因素，花粉与哮喘之间的关系研究较少，包括不同花粉类型之间以及亚组之间的关联差异，以及这种关联随时间的变化。
我们评估了 1993 年至 2018 年期间，佐治亚州亚特兰大市环境花粉浓度与哮喘和喘息急诊就诊之间的关联。我们对 13 种单一花粉分类群的整体关联进行了估计，还按十年、种族、年龄（5-17 岁、18-64 岁、65 岁以上）和保险状况（医疗补助与非医疗补助）进行了关联评估。
从亚特兰大过敏与哮喘（一家获得国家认证的花粉计数站）获取了分类花粉数据。从各医院和佐治亚州医院协会获取了急诊就诊数据。我们使用拟泊松分布滞后模型进行时间序列分析，主要分析评估了 3 天（滞后 0-2 天）花粉水平。模型控制了星期几、节假日、空气温度、月份、年份以及月-年交互作用。
1993 年至 2018 年期间，在该数据集中有 686259 例哮喘和喘息急诊就诊，且急诊就诊人数随时间增加。我们观察到哮喘和喘息急诊就诊与 13 种花粉分类群中的 9 种呈正相关：树木（枫、桦、松、栎、柳、梧桐和桑）、两种杂草（荨麻和猪殃殃）和草类。每标准偏差花粉增加，哮喘和喘息急诊就诊的比率增加 1-8%。一般而言，我们在最早的时期（1993-2000 年）、年轻人和黑人患者中观察到更强的关联；但是，结果因花粉分类群而异。
一些（而非全部）类型的花粉与哮喘/喘息急诊就诊增加有关。关联在黑人患者和年轻人中通常更高，且似乎随时间推移而降低。
