University of Wisconsin-Madison School of Medicine and Public Health, 610 Walnut St, Madison, WI, 53726, United States; Wisconsin Department of Health Services, 1 West Wilson St, Madison, WI, 53703, United States.
Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, United States.
Int J Hyg Environ Health. 2024 Jan;255:114272. doi: 10.1016/j.ijheh.2023.114272. Epub 2023 Oct 21.
Potential acute and chronic human health effects associated with exposure to cyanobacteria and cyanotoxins, including respiratory symptoms, are an understudied public health concern. We examined the relationship between estimated cyanobacteria biomass and the frequency of respiratory-related hospital visits for residents living near Green Bay, Lake Michigan, Wisconsin during 2017-2019. Remote sensing data from the Cyanobacteria Assessment Network was used to approximate cyanobacteria exposure through creation of a metric for cyanobacteria chlorophyll-a (Chl). We obtained counts of hospital visits for asthma, wheezing, and allergic rhinitis from the Wisconsin Hospital Association for ZIP codes within a 3-mile radius of Green Bay. We analyzed weekly counts of hospital visits versus cyanobacteria, which was modelled as a continuous measure (Chl) or categorized according to World Health Organization's (WHO) alert levels using Poisson generalized linear models. Our data included 2743 individual hospital visits and 114 weeks of satellite derived cyanobacteria biomass indicator data. Peak values of Chl were observed between the months of June and October. Using the WHO alert levels, 60% of weeks were categorized as no risk, 19% as Vigilance Level, 15% as Alert Level 1, and 6% as Alert Level 2. In Poisson regression models adjusted for temperature, dewpoint, season, and year, there was no association between Chl and hospital visits (rate ratio [RR] [95% Confidence Interval (CI)] = 0.98 [0.77, 1.24]). There was also no consistent association between WHO alert level and hospital visits when adjusting for covariates (Vigilance Level: RR [95% CI] 0.88 [0.74, 1.05], Alert Level 1: 0.82 [0.67, 0.99], Alert Level 2: 0.98 [0.77, 1.24], compared to the reference no risk category). Our methodology and model provide a template for future studies that assess the association between cyanobacterial blooms and respiratory health.
与暴露于蓝藻和蓝藻毒素相关的潜在急性和慢性人类健康影响，包括呼吸道症状，是一个研究不足的公共卫生关注点。我们研究了 2017 年至 2019 年期间，居住在威斯康星州密歇根湖格林湾附近的居民的蓝藻生物量估计值与呼吸道相关住院就诊频率之间的关系。利用蓝藻评估网络的遥感数据，通过创建蓝藻叶绿素-a (Chl) 指标来估算蓝藻暴露。我们从威斯康星州医院协会获得了格林湾 3 英里范围内邮政编码的哮喘、喘息和过敏性鼻炎的住院访问计数。我们分析了每周的住院就诊次数与蓝藻的关系，蓝藻以连续量 (Chl) 表示，或根据世界卫生组织 (WHO) 的警戒水平进行分类，使用泊松广义线性模型进行分析。我们的数据包括 2743 例单独的住院就诊和 114 周的卫星衍生蓝藻生物量指标数据。Chl 的峰值出现在 6 月至 10 月之间。使用世卫组织的警戒水平，60%的周被归类为无风险，19%为警戒水平 1，15%为警戒水平 1，6%为警戒水平 2。在调整温度、露点、季节和年份的泊松回归模型中，Chl 与住院就诊之间没有关联（比率比 [RR] [95%置信区间 (CI)]=0.98 [0.77, 1.24]）。在调整协变量后，世卫组织警戒水平与住院就诊之间也没有一致的关联（警戒水平 1：RR [95%CI] 0.88 [0.74, 1.05]，警戒水平 1：0.82 [0.67, 0.99]，警戒水平 2：0.98 [0.77, 1.24]，与参考无风险类别相比）。我们的方法和模型为未来评估蓝藻水华与呼吸道健康之间的关联提供了一个模板。
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