School of Geography Earth and Environmental Sciences, University of Birmingham, Birmingham, UK.
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
BMJ Open. 2024 Jan 23;14(1):e070704. doi: 10.1136/bmjopen-2022-070704.
The study aims to investigate the short-term associations between exposure to ambient air pollution (nitrogen dioxide (NO), particulate matter pollution-particles with diameter<2.5 µm (PM) and PM) and incidence of asthma hospital admissions among adults, in Oxford, UK.
Retrospective time-series study.
Oxford City (postcode areas OX1-OX4), UK.
Adult population living within the postcode areas OX1-OX4 in Oxford, UK from 1 January 2015 to 31 December 2021.
Hourly NO, PM and PM concentrations and meteorological data for the period 1 January 2015 to 31 December 2020 were analysed and used as exposures. We used Poisson linear regression analysis to identify independent associations between air pollutant concentrations and asthma admissions rate among the adult study population, using both single (NO, PM, PM) and multipollutant (NO and PM, NO and PM) models, where they adjustment for temperature and relative humidity.
The overall 5-year average asthma admissions rate was 78 per 100 000 population during the study period. The annual average rate decreased to 46 per 100 000 population during 2020 (incidence rate ratio 0.58, 95% CI 0.42 to 0.81, p<0.001) compared to the prepandemic years (2015-2019). In single-pollutant analysis, we observed a significantly increased risk of asthma admission associated with each 1 μg/m increase in monthly concentrations of NO 4% (95% CI 1.009% to 1.072%), PM 3% (95% CI 1.006% to 1.052%) and PM 1.8% (95% CI 0.999% to 1.038%). However, in the multipollutant regression model, the effect of each individual pollutant was attenuated.
Ambient NO and PM air pollution exposure increased the risk of asthma admissions in this urban setting. Improvements in air quality during COVID-19 lockdown periods may have contributed to a substantially reduced acute asthma disease burden. Large-scale measures to improve air quality have potential to protect vulnerable people living with chronic asthma in urban areas.
本研究旨在调查英国牛津市成年人接触环境空气污染（二氧化氮（NO）、细颗粒物污染-直径<2.5μm 的颗粒物（PM）和 PM）与哮喘住院发生率之间的短期关联。
回顾性时间序列研究。
牛津市（邮编区 OX1-OX4），英国。
2015 年 1 月 1 日至 2021 年 12 月 31 日期间居住在牛津邮编区 OX1-OX4 内的成年人群。
分析了 2015 年 1 月 1 日至 2020 年 12 月 31 日期间的每小时二氧化氮、PM 和 PM 浓度以及气象数据，并将其作为暴露因素。我们使用泊松线性回归分析，在调整温度和相对湿度的情况下，在成人研究人群中，使用单（NO、PM、PM）和多污染物（NO 和 PM、NO 和 PM）模型，分别识别空气污染物浓度与哮喘入院率之间的独立关联。
在研究期间，总体 5 年平均哮喘入院率为每 10 万人 78 人。与大流行前年份（2015-2019 年）相比，2020 年每年平均发病率下降至每 10 万人 46 人（发病率比 0.58，95%CI 0.42 至 0.81，p<0.001）。在单污染物分析中，我们观察到与每月浓度增加 1μg/m 的二氧化氮、细颗粒物和 PM 分别增加 4%（95%CI 1.009%至 1.072%）、3%（95%CI 1.006%至 1.052%）和 1.8%（95%CI 0.999%至 1.038%）相关的哮喘入院风险显著增加。然而，在多污染物回归模型中，每个单独污染物的影响减弱。
在这一城市环境中，环境空气中的二氧化氮和细颗粒物污染暴露增加了哮喘入院的风险。COVID-19 封锁期间空气质量的改善可能导致急性哮喘疾病负担大幅减轻。改善空气质量的大规模措施有可能保护城市地区患有慢性哮喘的弱势群体。
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