多种户外环境因素对哮喘发作风险的短期影响:年龄分层时间序列分析
2019/10/17
摘要
背景:虽然不同年龄组哮喘发作(AEs)对环境因素的敏感性存在差异，但尚未有全面的研究考察环境因素对AEs的年龄分层效应。
目的:探讨不同年龄层(婴幼儿、学龄前儿童、学龄儿童、成人和老年人)户外环境因素(空气污染物、天气条件、空气变应原和呼吸道病毒流行)对哮喘加重的短期影响。
方法:采用年龄分层的方法，对2008年至2012年韩国首尔市区4组户外环境因素对AEs的短期影响进行分析。统计分析采用泊松广义线性回归模型，分布滞后非线性模型用于滞后和非线性效应的识别，汇聚交叉映射用于因果关系的识别。
结果:对总人口数(n=10,233,519)的分析表明，在研究期间有28,824例急诊事件需要入院。日温范围对儿童(婴幼儿、学龄前儿童、学龄儿童)和老年人有显著影响(RR: 1.056-1.078、1.016)。乔木和杂草花粉、人鼻病毒和流感病毒对学龄儿童有显著影响(RR分别为1.014、1.040、1.042和1.038)。树花粉和流感病毒对成虫有显著影响(RR: 1.026和1.044)。室外空气污染物(PM, NO, O, CO, SO)对所有年龄组都有显著的短期影响(除了CO和SO对婴儿的影响)。
结论:这些发现为制定针对不同年龄组的哮喘发作事件的预防策略提供了必要的依据。
Abstract
BACKGROUND: Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to the environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs.,
OBJECTIVE: To examine the short-term effects of age-stratified groups (infants, preschool children, school-aged children, adults, and elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on asthma exacerbations.,
METHODS: We performed an age-stratified analysis of the short-term effects of four groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis employed a Poisson generalized linear regression model, with a distributed lag non-linear model for identification of lagged and non-linear effects and convergent cross mapping for identification of causal associations.,
RESULTS: Analysis of the total population (n=10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly people (RR: 1.056-1.078 and 1.016, respectively). Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-age children (RR: 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR: 1.026 and 1.044, respectively). Outdoor air pollutants (PM, NO, O, CO, and SO) had significant short-term effects in all age groups (except for CO and SO in infants).,
CONCLUSION: These findings provide the need for the development of tailored strategies to prevent asthma exacerbation events in different age groups.
背景:虽然不同年龄组哮喘发作(AEs)对环境因素的敏感性存在差异，但尚未有全面的研究考察环境因素对AEs的年龄分层效应。
目的:探讨不同年龄层(婴幼儿、学龄前儿童、学龄儿童、成人和老年人)户外环境因素(空气污染物、天气条件、空气变应原和呼吸道病毒流行)对哮喘加重的短期影响。
方法:采用年龄分层的方法，对2008年至2012年韩国首尔市区4组户外环境因素对AEs的短期影响进行分析。统计分析采用泊松广义线性回归模型，分布滞后非线性模型用于滞后和非线性效应的识别，汇聚交叉映射用于因果关系的识别。
结果:对总人口数(n=10,233,519)的分析表明，在研究期间有28,824例急诊事件需要入院。日温范围对儿童(婴幼儿、学龄前儿童、学龄儿童)和老年人有显著影响(RR: 1.056-1.078、1.016)。乔木和杂草花粉、人鼻病毒和流感病毒对学龄儿童有显著影响(RR分别为1.014、1.040、1.042和1.038)。树花粉和流感病毒对成虫有显著影响(RR: 1.026和1.044)。室外空气污染物(PM, NO, O, CO, SO)对所有年龄组都有显著的短期影响(除了CO和SO对婴儿的影响)。
结论:这些发现为制定针对不同年龄组的哮喘发作事件的预防策略提供了必要的依据。
(中日友好医院呼吸与危重症医学科 张清 摘译 林江涛 审校)
(J Allergy Clin Immunol. 2019 Sep 16. pii: S0091-6749(19)31185-6. doi: 10.1016/j.jaci.2019.08.037)
(J Allergy Clin Immunol. 2019 Sep 16. pii: S0091-6749(19)31185-6. doi: 10.1016/j.jaci.2019.08.037)
Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: age-stratified time-series analysis.
Lee SW, Yon DK, James CC, Lee S, Koh HY, Sheen YH, Oh JW, Han MY, Sugihara G.
Abstract
BACKGROUND: Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to the environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs.,
OBJECTIVE: To examine the short-term effects of age-stratified groups (infants, preschool children, school-aged children, adults, and elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on asthma exacerbations.,
METHODS: We performed an age-stratified analysis of the short-term effects of four groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis employed a Poisson generalized linear regression model, with a distributed lag non-linear model for identification of lagged and non-linear effects and convergent cross mapping for identification of causal associations.,
RESULTS: Analysis of the total population (n=10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly people (RR: 1.056-1.078 and 1.016, respectively). Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-age children (RR: 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR: 1.026 and 1.044, respectively). Outdoor air pollutants (PM, NO, O, CO, and SO) had significant short-term effects in all age groups (except for CO and SO in infants).,
CONCLUSION: These findings provide the need for the development of tailored strategies to prevent asthma exacerbation events in different age groups.
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全球重症哮喘的描述：来自国际重症哮喘登记(ISAR)
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多种户外环境因素对哮喘急性发作风险的短期影响：年龄分层时间序列分析
