摘要
背景：哮喘是儿童中一种常见的慢性呼吸道疾病，受到各种气候和环境因素的影响。尽管哮喘很普遍，但这些因素对哮喘的具体影响仍不清楚。本研究旨在利用时空方法系统评估气候和环境因素对儿童哮喘影响的流行病学证据。
方法：为了分析气候和环境因素对儿童哮喘和喘息的影响，我们进行了一项系统性综述，重点关注空间和时间趋势。我们在 PubMed、Embase 和 CINAHL 数据库中检索了 2000 年 1 月至 2024 年 4 月期间发表的研究，检索关键词为 “哮喘/喘息”、“极端天气”、“绿色空间”、“空气污染 ”和 “空间或时间分析”。
结果：系统综述分析了 28 项研究，其中 6 项采用了空间分析方法，22 项采用了时间分析方法；但是，没有一项研究在其模型中纳入时空分析。研究结果表明，包括热浪和暴雨在内的极端天气事件会在不同气候条件下增加儿童哮喘的风险，在夏季和冬季会产生显著影响。干旱和亚热带地区的沙尘暴与哮喘恶化导致的入院人数激增有关。绿地对儿童哮喘的影响好坏参半，一些研究表明具有保护作用，而另一些研究则表明受当地环境因素的影响，风险会增加。PM2.5、二氧化氮和臭氧等空气污染物会加重哮喘症状，并与其他环境因素一起造成季节性影响。高温通常与哮喘风险的增加有关，但其影响因年龄、性别和气候而异。
结论：未来的研究应整合空间和时间方法，以更好地了解环境和气候变化对儿童哮喘的影响。
Effects of climate and environmental factors on childhood and adolescent asthma: A systematic review based on spatial and temporal analysis evidence
Wang J, Cortes-Ramirez J, Gan T, Davies JM, Hu W.
Abstract
Background:Asthma is a prevalent chronic respiratory disease among children, influenced by various climate and environmental factors. Despite its prevalence, the specific effects of these factors on asthma remain unclear. This study aims to systematically assess the epidemiological evidence using spatial and temporal methods on the impact of climate and environmental factors on childhood asthma.
Methods:A systematic review was conducted to analyse the impact of climate and environmental factors on childhood asthma and wheezing, focusing on spatial and temporal trends. Searches were carried out in PubMed, Embase, and CINAHL databases for studies published from January 2000 to April 2024, using key search terms 'asthma/wheezing', 'extreme weather, 'green space', 'air pollution' and 'spatial or temporal analyses".
Results:The systematic review analysed 28 studies, with six employing spatial and 22 using temporal analysis methods; however, none incorporated spatio-temporal analysis in their models. The findings reveal that extreme weather events, including heatwaves and heavy rainfall, elevate childhood asthma risks across various climates, with significant effects observed during summer and winter months. Dust storms in arid and subtropical regions are linked to immediate spikes in hospital admissions due to asthma exacerbations. The effects of green spaces on childhood asthma are mixed, with some studies indicating protective effects while others suggest increased risks, influenced by local environmental factors. Air pollutants such as PM2.5, NO2, and ozone can exacerbate asthma symptoms and along with other environmental factors, contribute to seasonal effects. High temperatures generally correlate with increased asthma risks, though the effects vary by age, sex, and climate.
Conclusion:Future research should integrate spatial and temporal methods to better understand the effects of environmental and climate changes on childhood asthma.
背景：哮喘是儿童中一种常见的慢性呼吸道疾病，受到各种气候和环境因素的影响。尽管哮喘很普遍，但这些因素对哮喘的具体影响仍不清楚。本研究旨在利用时空方法系统评估气候和环境因素对儿童哮喘影响的流行病学证据。
方法：为了分析气候和环境因素对儿童哮喘和喘息的影响，我们进行了一项系统性综述，重点关注空间和时间趋势。我们在 PubMed、Embase 和 CINAHL 数据库中检索了 2000 年 1 月至 2024 年 4 月期间发表的研究，检索关键词为 “哮喘/喘息”、“极端天气”、“绿色空间”、“空气污染 ”和 “空间或时间分析”。
结果：系统综述分析了 28 项研究，其中 6 项采用了空间分析方法，22 项采用了时间分析方法；但是，没有一项研究在其模型中纳入时空分析。研究结果表明，包括热浪和暴雨在内的极端天气事件会在不同气候条件下增加儿童哮喘的风险，在夏季和冬季会产生显著影响。干旱和亚热带地区的沙尘暴与哮喘恶化导致的入院人数激增有关。绿地对儿童哮喘的影响好坏参半，一些研究表明具有保护作用，而另一些研究则表明受当地环境因素的影响，风险会增加。PM2.5、二氧化氮和臭氧等空气污染物会加重哮喘症状，并与其他环境因素一起造成季节性影响。高温通常与哮喘风险的增加有关，但其影响因年龄、性别和气候而异。
结论：未来的研究应整合空间和时间方法，以更好地了解环境和气候变化对儿童哮喘的影响。
(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)
(Sci Total Environ. 2024 Nov 15; DOI: 10.1016/j.scitotenv.2024.175863)
(Sci Total Environ. 2024 Nov 15; DOI: 10.1016/j.scitotenv.2024.175863)
Effects of climate and environmental factors on childhood and adolescent asthma: A systematic review based on spatial and temporal analysis evidence
Wang J, Cortes-Ramirez J, Gan T, Davies JM, Hu W.
Abstract
Background:Asthma is a prevalent chronic respiratory disease among children, influenced by various climate and environmental factors. Despite its prevalence, the specific effects of these factors on asthma remain unclear. This study aims to systematically assess the epidemiological evidence using spatial and temporal methods on the impact of climate and environmental factors on childhood asthma.
Methods:A systematic review was conducted to analyse the impact of climate and environmental factors on childhood asthma and wheezing, focusing on spatial and temporal trends. Searches were carried out in PubMed, Embase, and CINAHL databases for studies published from January 2000 to April 2024, using key search terms 'asthma/wheezing', 'extreme weather, 'green space', 'air pollution' and 'spatial or temporal analyses".
Results:The systematic review analysed 28 studies, with six employing spatial and 22 using temporal analysis methods; however, none incorporated spatio-temporal analysis in their models. The findings reveal that extreme weather events, including heatwaves and heavy rainfall, elevate childhood asthma risks across various climates, with significant effects observed during summer and winter months. Dust storms in arid and subtropical regions are linked to immediate spikes in hospital admissions due to asthma exacerbations. The effects of green spaces on childhood asthma are mixed, with some studies indicating protective effects while others suggest increased risks, influenced by local environmental factors. Air pollutants such as PM2.5, NO2, and ozone can exacerbate asthma symptoms and along with other environmental factors, contribute to seasonal effects. High temperatures generally correlate with increased asthma risks, though the effects vary by age, sex, and climate.
Conclusion:Future research should integrate spatial and temporal methods to better understand the effects of environmental and climate changes on childhood asthma.
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