极端天气和哮喘:一项系统回顾和荟萃分析
2023/06/25
摘要
背景：气候变化对极端天气事件的影响对哮喘患者的发病率和死亡率构成重大威胁。这项研究的目的是调查极端天气事件和哮喘相关结果之间的联系。
方法：使用PubMed、EMBASE、Web of Science和ProQuest数据库对相关研究进行系统的文献检索。应用固定效应和随机效应模型来估计极端天气事件对哮喘相关结果的影响。
结果：我们观察到，极端天气事件与一般哮喘结局的风险增加相关，哮喘事件的相对风险为1.18倍(95%CI 1.13-1.24)，哮喘症状的相对风险为1.10倍(95%CI 1.03-1.18)，哮喘诊断的相对风险为1.09倍(95%CI 1.00-1.19)。极端天气事件与急性哮喘发作风险增加相关，哮喘急诊科就诊的风险比为1.25倍(95%CI 1.14-1.37)，哮喘住院的风险比为1.10倍(95%CI 1.04-1.17)，哮喘门诊就诊的风险比为1.19倍(95%CI 1.06-1.34)，哮喘死亡率的风险比为2.10倍(95%CI 1.35-3.27)。此外，极端天气事件的增加使儿童哮喘事件的风险比增加1.19倍(95%CI 1.08-1.32)，女性增加1.29倍(95%CI 0.98-1.69)。雷暴使哮喘事件的风险比增加1.24倍(95% CI 1.13-1.36)。
结论：我们的研究表明，极端天气事件更显著地增加了儿童和女性哮喘发病率和死亡率的风险。气候变化是哮喘控制的一个关键问题。
Extreme weather and asthma: a systematic review and meta-analysis
F. Makrufardi, A. Manullang, D. Rusmawatiningtyas, K. F. Chung, S. C. Lin and H. C. Chuang
Abstract
BACKGROUND:Climate change’s influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes.
METHODS:A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes.
RESULTS: We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13–1.24), 1.10-fold for asthma symptoms (95% CI 1.03–1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00–1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14–1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04–1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06–1.34) and of asthma mortality of 2.10-fold (95% CI 1.35–3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08–1.32 and 95% CI 0.98–1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13–1.36).
CONCLUSIONS: Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.
背景：气候变化对极端天气事件的影响对哮喘患者的发病率和死亡率构成重大威胁。这项研究的目的是调查极端天气事件和哮喘相关结果之间的联系。
方法：使用PubMed、EMBASE、Web of Science和ProQuest数据库对相关研究进行系统的文献检索。应用固定效应和随机效应模型来估计极端天气事件对哮喘相关结果的影响。
结果：我们观察到，极端天气事件与一般哮喘结局的风险增加相关，哮喘事件的相对风险为1.18倍(95%CI 1.13-1.24)，哮喘症状的相对风险为1.10倍(95%CI 1.03-1.18)，哮喘诊断的相对风险为1.09倍(95%CI 1.00-1.19)。极端天气事件与急性哮喘发作风险增加相关，哮喘急诊科就诊的风险比为1.25倍(95%CI 1.14-1.37)，哮喘住院的风险比为1.10倍(95%CI 1.04-1.17)，哮喘门诊就诊的风险比为1.19倍(95%CI 1.06-1.34)，哮喘死亡率的风险比为2.10倍(95%CI 1.35-3.27)。此外，极端天气事件的增加使儿童哮喘事件的风险比增加1.19倍(95%CI 1.08-1.32)，女性增加1.29倍(95%CI 0.98-1.69)。雷暴使哮喘事件的风险比增加1.24倍(95% CI 1.13-1.36)。
结论：我们的研究表明，极端天气事件更显著地增加了儿童和女性哮喘发病率和死亡率的风险。气候变化是哮喘控制的一个关键问题。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Eur Respir Rev 2023 Vol. 32 Issue 168 DOI: 10.1183/16000617.0019-2023）
（Eur Respir Rev 2023 Vol. 32 Issue 168 DOI: 10.1183/16000617.0019-2023）
Extreme weather and asthma: a systematic review and meta-analysis
F. Makrufardi, A. Manullang, D. Rusmawatiningtyas, K. F. Chung, S. C. Lin and H. C. Chuang
Abstract
BACKGROUND:Climate change’s influence on extreme weather events poses a significant threat to the morbidity and mortality of asthma patients. The aim of this study was to examine associations between extreme weather events and asthma-related outcomes.
METHODS:A systematic literature search for relevant studies was performed using the PubMed, EMBASE, Web of Science and ProQuest databases. Fixed-effects and random-effects models were applied to estimate the effects of extreme weather events on asthma-related outcomes.
RESULTS: We observed that extreme weather events were associated with increasing risks of general asthma outcomes with relative risks of 1.18-fold for asthma events (95% CI 1.13–1.24), 1.10-fold for asthma symptoms (95% CI 1.03–1.18) and 1.09-fold for asthma diagnoses (95% CI 1.00–1.19). Extreme weather events were associated with increased risks of acute asthma exacerbation with risk ratios of asthma emergency department visits of 1.25-fold (95% CI 1.14–1.37), of asthma hospital admissions of 1.10-fold (95% CI 1.04–1.17), of asthma outpatient visits of 1.19-fold (95% CI 1.06–1.34) and of asthma mortality of 2.10-fold (95% CI 1.35–3.27). Additionally, an increase in extreme weather events increased risk ratios of asthma events by 1.19-fold in children and 1.29-fold in females (95% CI 1.08–1.32 and 95% CI 0.98–1.69, respectively). Thunderstorms increased the risk ratio of asthma events by 1.24-fold (95% CI 1.13–1.36).
CONCLUSIONS: Our study showed that extreme weather events more prominently increased the risk of asthma morbidity and mortality in children and females. Climate change is a critical concern for asthma control.
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童年至中年期间纵向哮喘表型研究：一项基于人群的队列研究
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