Assessing effects of personal behaviors and environmental exposure on asthma episodes: a diary-based approach
Assessing effects of personal behaviors and environmental exposure on asthma episodes: a diary-based approach
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DOI：
10.1186/s12890-019-0998-0
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发表时间：
2019-12-02
影响因子：
3.1
通讯作者：
Hwang, Jing-Shiang
中科院分区：
文献类型：
--
作者：
Chan, Ta-Chien;Hu, Tsuey-Hwa;Hwang, Jing-Shiang
背景：量化个人健康行为和环境暴露对哮喘发作的影响是一个挑战。大多数研究都集中在监测症状和缓解症状的药物使用上。在这项研究中，我们强调需要了解个人和环境条件是如何与哮喘症状的发生相关的。方法我们设计了一个在线健康日记平台，收集患有哮喘、过敏性鼻炎、特应性皮炎和过敏性结膜炎等过敏性疾病的儿童及其父母和其他成年人的个人健康行为。参与者使用移动设备或电脑记录他们每天与健康相关的活动，如睡眠、锻炼、饮食、对空气质量和温度的感知以及哮喘症状。参与者还记录了二手烟暴露量和活动时间，并与环境空气质量测量相结合，计算个人空气污染暴露量。采用广义线性混合模型估计各因素的影响。结果在研究期间(2017年1月至2017年6月，2017年10月至2018年9月)，132名参与者提供了25016个日记条目，在1458个日记条目中，84名参与者出现了哮喘症状。结果显示，对于未成年人和成年人来说，存在不同的危险因素。对于未成年人来说，高强度运动、接触流感样疾病(ILI)患者以及感觉高温和室内空气质量差与哮喘发作有关。已确定的成年参与者的危险因素包括在家中安装除湿器、接触二手烟、睡眠质量差、接触ILI患者、不吃水果和海鲜、感觉到寒冷的温度、室内和室外空气质量不佳，以及暴露在高浓度臭氧中。结论揭示的个人危险因素和对空气质量和温度的感知可能为哮喘易感人群提供行为改变的指导，以帮助控制哮喘的急性发作和严重加重。
Background Quantifying the effects of personal health behaviors and environmental exposure on asthma flare-ups is a challenge. Most studies have focused on monitoring the symptoms and drug usage for relieving symptoms. In this study, we emphasize the need to understand how personal and environmental conditions are related to the occurrence of asthma symptoms. Methods We designed an online health diary platform to collect personal health behaviors from children, their parents and other adults with any allergic diseases including asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis. The participants used mobile devices or computers to record their daily health-related activities such as sleep, exercise, diet, perception of air quality and temperature, and asthma symptoms. The participants also recorded secondhand smoke exposure and the time of activities, which were combined with ambient air quality measurements for calculating personal air pollution exposure. A generalized linear mixed model was used to estimate the effects of the factors. Results During the study period (January 2017-June 2017, and October 2017-September 2018), 132 participants provided 25,016 diary entries, and 84 participants had experienced asthma symptoms in 1458 diary entries. The results showed some different risk factors for the minors and adults. For minors, high-intensity exercise, contact with persons with influenza-like illness (ILI) and the perception of hot temperature and bad indoor air quality were associated with the occurrence of asthma episodes. The identified risk factors for the adult participants included having dehumidifiers at home, exposure to secondhand smoke, having bad sleep quality, contact with persons with ILI, not eating fruit and seafood, perceiving cold temperature, bad quality of indoor and outdoor air, and exposure to high concentration of ozone. Conclusions The revealed personal risk factors and perceptions of air quality and temperature may provide guidance on behavioral change for people susceptible to asthma to help control acute onset and severe exacerbation of asthma flare-ups.