空气中的草花粉和雷暴影响亚热带气候下的哮喘急诊就诊率
2023/08/28
摘要
背景：草属花粉被认为是全球主要的户外气溶胶过敏原来源。有提出一种关于雷暴哮喘的机制，即在雷暴期间，闪电促使花粉颗粒发生电击破裂，从而导致过敏性气道炎症。然而，大多数关于草属花粉和哮喘之间的关联证据来自温带地区。本研究的目标是调查亚热带人群中空气中草属花粉暴露与哮喘急诊科就诊之间的短期关联。
方法：从澳大利亚昆士兰州卫生部的急诊数据收集中提取了大布里斯班地区（2016-2020年）哮喘的就诊记录。采用连续流体容积冲击采样器预测测定了空气中花粉的浓度。使用广义加性混合模型进行了每日时间序列分析，以确定空气中草属花粉浓度和闪电次数与哮喘就诊之间的关联。
结果：空气中草属花粉与布里斯班地区的哮喘就诊存在关联；从暴露当天到三天滞后期之间检测到显著关联。在女童中，草属花粉暴露导致每日哮喘就诊增加了高达48.5%（95% CI：12%，85.9%）。闪电未改变草属花粉对哮喘就诊的影响，但在云与云之间的闪电打击与哮喘就诊之间检测到了正向关联（P = 0.048）。
结论：在亚热带气候中，空气中草属花粉暴露可能加剧儿童和成人的哮喘症状，需要紧急医疗护理。这一认识表明，在减轻患者和卫生系统负担方面，有机会针对性地管理呼吸道过敏性疾病。首次在这种情况下检测到了闪电对哮喘的影响。研究结果支持在亚热带地区继续进行花粉监测和雷暴哮喘风险监测的需要。
Simunovic M, Boyle J, Erbas B, Baker P, Davies JM.
Abstract
Background:Grass pollen is considered a major outdoor aeroallergen source worldwide. It is proposed as a mechanism for thunderstorm asthma that lightning during thunderstorms promotes electrical rupture of pollen grains that leads to allergic airway inflammation. However, most evidence of associations between grass pollen and asthma comes from temperate regions. The objective of this study was to investigate short-term associations between airborne grass pollen exposure and asthma emergency department presentations in a subtropical population.
Methods:Episode level public hospital presentations for asthma (2016-2020) were extracted for greater Brisbane, Australia, from Queensland Health's Emergency Data Collection. Concentrations of airborne pollen were determined prospectively using a continuous flow volumetric impaction sampler. Daily time series analysis using a generalised additive mixed model were applied to determine associations between airborne grass pollen concentrations, and lightning count data, with asthma presentations.
Results:Airborne grass pollen showed an association with asthma presentations in Brisbane; a significant association was detected from same day exposure to three days lag. Grass pollen exposure increased daily asthma presentations up to 48.5% (95% CI: 12%, 85.9%) in female children. Lightning did not modify the effect of grass pollen on asthma presentations, however a positive association was detected between cloud-to-cloud lightning strikes and asthma presentations (P = 0.048).
Conclusion:Airborne grass pollen exposure may exacerbate symptoms of asthma requiring urgent medical care of children and adults in a subtropical climate. This knowledge indicates an opportunity for targeted management of respiratory allergic disease to reduce patient and health system burden. For the first time, an influence of lightning on asthma was detected in this context. The outcomes support a need for continued pollen monitoring and surveillance of thunderstorm asthma risk in subtropical regions.
背景：草属花粉被认为是全球主要的户外气溶胶过敏原来源。有提出一种关于雷暴哮喘的机制，即在雷暴期间，闪电促使花粉颗粒发生电击破裂，从而导致过敏性气道炎症。然而，大多数关于草属花粉和哮喘之间的关联证据来自温带地区。本研究的目标是调查亚热带人群中空气中草属花粉暴露与哮喘急诊科就诊之间的短期关联。
方法：从澳大利亚昆士兰州卫生部的急诊数据收集中提取了大布里斯班地区（2016-2020年）哮喘的就诊记录。采用连续流体容积冲击采样器预测测定了空气中花粉的浓度。使用广义加性混合模型进行了每日时间序列分析，以确定空气中草属花粉浓度和闪电次数与哮喘就诊之间的关联。
结果：空气中草属花粉与布里斯班地区的哮喘就诊存在关联；从暴露当天到三天滞后期之间检测到显著关联。在女童中，草属花粉暴露导致每日哮喘就诊增加了高达48.5%（95% CI：12%，85.9%）。闪电未改变草属花粉对哮喘就诊的影响，但在云与云之间的闪电打击与哮喘就诊之间检测到了正向关联（P = 0.048）。
结论：在亚热带气候中，空气中草属花粉暴露可能加剧儿童和成人的哮喘症状，需要紧急医疗护理。这一认识表明，在减轻患者和卫生系统负担方面，有机会针对性地管理呼吸道过敏性疾病。首次在这种情况下检测到了闪电对哮喘的影响。研究结果支持在亚热带地区继续进行花粉监测和雷暴哮喘风险监测的需要。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Environ Res. 2023 Jul 26. DOI: 10.1016/j.envres.2023.116754)
Airborne grass pollen and thunderstorms influence emergency department asthma presentations in a subtropical climate(Environ Res. 2023 Jul 26. DOI: 10.1016/j.envres.2023.116754)
Simunovic M, Boyle J, Erbas B, Baker P, Davies JM.
Abstract
Background:Grass pollen is considered a major outdoor aeroallergen source worldwide. It is proposed as a mechanism for thunderstorm asthma that lightning during thunderstorms promotes electrical rupture of pollen grains that leads to allergic airway inflammation. However, most evidence of associations between grass pollen and asthma comes from temperate regions. The objective of this study was to investigate short-term associations between airborne grass pollen exposure and asthma emergency department presentations in a subtropical population.
Methods:Episode level public hospital presentations for asthma (2016-2020) were extracted for greater Brisbane, Australia, from Queensland Health's Emergency Data Collection. Concentrations of airborne pollen were determined prospectively using a continuous flow volumetric impaction sampler. Daily time series analysis using a generalised additive mixed model were applied to determine associations between airborne grass pollen concentrations, and lightning count data, with asthma presentations.
Results:Airborne grass pollen showed an association with asthma presentations in Brisbane; a significant association was detected from same day exposure to three days lag. Grass pollen exposure increased daily asthma presentations up to 48.5% (95% CI: 12%, 85.9%) in female children. Lightning did not modify the effect of grass pollen on asthma presentations, however a positive association was detected between cloud-to-cloud lightning strikes and asthma presentations (P = 0.048).
Conclusion:Airborne grass pollen exposure may exacerbate symptoms of asthma requiring urgent medical care of children and adults in a subtropical climate. This knowledge indicates an opportunity for targeted management of respiratory allergic disease to reduce patient and health system burden. For the first time, an influence of lightning on asthma was detected in this context. The outcomes support a need for continued pollen monitoring and surveillance of thunderstorm asthma risk in subtropical regions.
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英国儿童及青少年中支气管哮喘诊断、学龄前喘息诊断及哮喘急性发作最新趋势：SABINA Jr研究
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流感与其他呼吸道病毒——评估住院儿童的严重程度，比利时，2011 年至 2020 年
