空气指标预测小学儿童哮喘发作：宾夕法尼亚州每日环境调查联合学校卫生监督的研究
2012/07/06
摘要
目的：为研究小学儿童哮喘发作是否与每日空气指标（温度、相对湿度、露点、混合比）相关；如果相关，则继续构建能预测儿童哮喘发作的数学模型。
方法：采用生态学研究设计，对宾夕法尼亚州49个地区参与学校健康网络工具项目的168825名小学生的学校健康记录进行分析。有关哮喘发作的数据最先由学校护士记录，基于指定时间学生临床就诊时医生所提供的治疗方案判断是否存在哮喘发作。每日对地面至850 mb压力之间的空气进行检测，覆盖匹兹堡方圆800公里的范围。采用Wilcoxon两样本检验评价两者的相关性。采用广义估计方程模型预测超过48次的哮喘发作，2008年～2010年的每日平均值。
结果：对宾夕法尼亚州小学生哮喘的监控在3年内逐年加强。哮喘发作出现最多的是秋季，其次为夏季、春季和冬季。不同季节之间空气观察指标年平均值存在显著差异（P <0.02）。高于3年平均值的空气温度、露点和混合比以及空气相对湿度≥ 50%与哮喘发作发生相关（P< 0.011）。
结论：监测空气指标是预测小学儿童哮喘发作的可靠方法。该方法有助于家长和学校护士采取有效的预防措施。
(林江涛 审校)
J Asthma. 2012 May 11. [Epub ahead of print]
J Asthma. 2012 May 11. [Epub ahead of print]
Source
Department of Applied Health Science, Indiana University , Bloomington, IN , USA.
Abstract
OBJECTIVE：To determine whether a relationship exists between asthma exacerbations among elementary school children and daily upper-air observations (temperature, relative humidity, dew point, and mixing ratio) and, if so, to derive a mathematical model that predicts asthma exacerbations among children.
METHODS：Using an ecological study design, school health records of 168,825 elementary school students enrolled in the Health eTools for Schools program within 49 Pennsylvania counties were analyzed. Data representing asthma exacerbations were originally recorded by school nurses as the type of treatment given to a student during a clinic visit on a particular day. Daily upper-air measurements from ground level to the 850 mb pressure level, covering a radius of 800 km around Pittsburgh, PA, were obtained. The Wilcoxon two-sample test was used to identify associations. A generalized estimating equation model was used to predict the occurrence of more than 48 asthma exacerbations, the daily mean for 2008-2010.
RESULTS：Surveillance of asthma among school children in Pennsylvania increased over 3 years. The greatest occurrence was in the fall, followed by summer, spring, and winter. Annual averages of upper-air observations were significantly different between seasons (p < .02). Upper-air temperature, dew point, and mixing ratio above their 3-year mean values and upper-air relative humidity ≥ 50% were significantly associated with occurrence of asthma exacerbations (p < .011).
CONCLUSIONS：Monitoring of upper-air observation data over time can be a reliable means for predicting increases of asthma exacerbations among elementary school children. Such predictions could help parents and school nurses implement effective precautionary measures.
J Asthma. 2012 May 11. [Epub ahead of print]
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流行病学研究中，比较三种方法对哮喘的检测：来自丹麦国家出生队列研究
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生命早期肺功能和1岁内的呼吸病转归
