哮喘联盟

   摘要
   目的：我们评估了印第安纳州印第安纳波利斯每天环境空气污染物变化与每天哮喘相关急诊科（ED）入住的短期相关性。
   方法：我们从≥5岁的印第安纳波利斯居民中鉴定出哮喘相关ED入住情况。我们采用泊松回归在时间序列框架中评估2007-2011年间温暖季节（4-9月）周围环境SO2、PM2.5和臭氧以及寒冷季节（10月-次年3月）SO2、PM2.5对哮喘相关ED入住增加的风险。我们的模型校正检测的混杂因素，包括天气和呼吸道感染，并采用三次自然样条函数校正未检测的混杂素来反应长期的季节趋势。
   结果：在印第安纳波利斯，2007-2011年间共发生165 056例哮喘相关ED入住。我们发现在温暖季节5-44岁人群中，环境空气污染物与ED入住存在显著的正相关(p < 0.05)。同一天、滞后2天和3天移动平均线的每日臭氧浓度的四分位间距增加与增加的ED入住风险相关。，增加的风险分别为 3.2% (95% 可信区间: 0.2%, 6.3%)，4.4% (0.1%, 8.9%) 和4.8% (0.2%, 9.6%)。SO2的3天移动平均线的四分位间距增加能增加3.3%的风险（95% 可信区间: 0.2%, 6.5%）。我们发现在一些年龄组，增加的 SO2 和PM2.5 水平与降低的ED入住统计学上存在显著相关，这种相关性主要在寒冷季节。PM2.5浓度变化与哮喘相关ED入住无显著正相关关系。
   结论：在温暖季节，臭氧和SO2浓度的增加与印第安纳波利斯地区儿童和年轻成人哮喘发病率增加相关。这些结果将为印第安纳波利斯和类似地区环境污染物增加对哮喘相关ED入住的健康影响提供可靠估计。
 

（苏欣 审校）
J Asthma. 2015 Oct 30:1-8. [Epub ahead of print]


 

Short-term effects of ambient air pollutants on asthma-related emergency department visits in Indianapolis, Indiana, 2007-2011.
 

Byers N1, Ritchey M2, Vaidyanathan A3, Brandt AJ4, Yip F3.
 

Abstract
OBJECTIVE:We estimate the short-term associations between daily changes in ambient air pollutants and daily asthma-related emergency department (ED) visits in Indianapolis, IN.
METHODS:We identified asthma-related ED visits among Indianapolis residents aged ≥5 years. We used Poisson regression in a time-series framework to estimate the increased risk for asthma-related ED visits from exposure to ambient SO2, PM2.5 and ozone during the warm season (April-September) and SO2 and PM2.5during the cold (October-March) season, from 2007 to 2011. Our models controlled for measured confounders, including weather and respiratory infections, as well as unmeasured confounders using a natural cubic spline to account for long-term seasonal trends.
RESULTS:During 2007-2011 in Indianapolis, 165 056 asthma-related ED visits occurred. We found statistically significant positive associations (p < 0.05) between ambient air pollutants and ED visits during the warm season for persons aged 5-44 years. Interquartile range increases in daily ozone concentrations with same day, 2-day lagged, and 3-day moving average were associated with increased risks for ED visits of 3.2% (95% CI: 0.2%, 6.3%), 4.4% (0.1%, 8.9%) and 4.8% (0.2%, 9.6%), respectively. Interquartile range increases in 3-day moving averages for SO2 were associated with an increased risk of 3.3% (95% CI: 0.2%, 6.5%). We identified statistically significant associations (p < 0.05) between increased SO2 and PM2.5 levels and decreased ED visits among some age groups, primarily during the cold season, and no significant positive associations between changes in PM2.5 concentration and asthma-related ED visits.
CONCLUSIONS:During the warm season, increases in ozone and SO2 concentrations were associated with increased asthma morbidity in children and young adults in Indianapolis. These results will enable reliable estimation of the health impacts of increases in these pollutants on asthma-related ED visits in Indianapolis and similar communities.
 

J Asthma. 2015 Oct 30:1-8. [Epub ahead of print]