Departments of Emergency and Critical Care Medicine.
Community-Based Medical Systems, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Pediatrics. 2024 Sep 1;154(3). doi: 10.1542/peds.2023-065381.
Victims of natural disasters are exposed to air pollution, changes in living conditions, and physical/emotional stress, which leads to exacerbation of asthma. The study aimed to examine the association between being victims of a natural disaster and asthma medication prescriptions among children and adolescents by comparing those affected and unaffected by the 2018 Japan floods.
Within the most severely impacted regions, a 1-year postdisaster retrospective cohort study was conducted on the basis of the National Health Insurance Claims Database. Participants aged 0 to 19 years with no record of asthma treatment in the year preceding the disaster were included in the analysis. The cumulative incidence of newly prescribed asthma inhalers in the 12 months after the disasters was compared between victims and nonvictims using survival analysis. To test the robustness, a difference-in-differences analysis was performed, including participants with a history of asthma prescriptions.
Of the 1 073 170 participants included in the study, 4425 (0.40%) were assigned to the victim group. Of these, 287 individuals (6.5%) from the victim group and 59 469 individuals (5.6%) from the nonvictim group were newly prescribed asthma inhalers within the year after the floods. Survival analysis revealed that victims were more prone to receiving inhaler prescriptions compared with nonvictims (adjusted hazard ratio 1.30; 95% confidence interval 1.16-1.46). Consistent results were obtained from the difference-in-differences analysis.
The 2018 Japan floods increased the demand for asthma inhalers among flood victims, underscoring the general implication that natural disasters can increase the incidence of asthma.
自然灾害受害者会暴露于空气污染、生活条件改变和身体/情绪压力下，这会导致哮喘恶化。本研究旨在通过比较受 2018 年日本洪灾影响和未受影响的儿童和青少年，来检验成为自然灾害受害者与哮喘药物处方之间的关联。
在受灾最严重的地区，基于国家健康保险索赔数据库进行了一项为期 1 年的灾后回顾性队列研究。分析纳入了在灾难前 1 年无哮喘治疗记录且年龄在 0 至 19 岁的参与者。使用生存分析比较了灾害后 12 个月内新开具哮喘吸入器的累积发生率。为了检验稳健性，进行了差异中的差异分析，包括有哮喘处方史的参与者。
在纳入的 1073170 名参与者中，4425 名（0.40%）被分配到受害者组。其中，287 名（6.5%）来自受害者组的个体和 59469 名（5.6%）来自非受害者组的个体在洪水后 1 年内新开具了哮喘吸入器。生存分析显示，与非受害者相比，受害者更有可能接受吸入器处方（调整后的危险比 1.30；95%置信区间 1.16-1.46）。差异中的差异分析也得到了一致的结果。
2018 年日本洪水增加了洪水受害者对哮喘吸入器的需求，这突显了一个普遍的观点，即自然灾害可能会增加哮喘的发病率。
