Temporal associations between daily counts of fungal spores and asthma exacerbations
Temporal associations between daily counts of fungal spores and asthma exacerbations
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DOI：
10.1136/oem.2005.024448
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发表时间：
2006-09-01
影响因子：
4.9
通讯作者：
Emberlin, J.
中科院分区：
文献类型：
--
作者：
Atkinson, R. W.;Strachan, D. P.;Emberlin, J.
背景：室外空气过敏原被认为是导致哮喘加重的众多环境因素之一。目的：研究大型城市人群中每日真菌孢子浓度与每日哮喘加重指标之间的短期关系。方法：收集1992- 1993年伦敦地区家庭医生、医院急诊科哮喘患者每日就诊次数和急诊入院次数。收集了真菌孢子（30种）的日平均浓度、日平均温度、日平均湿度、花粉浓度和室外空气污染情况。分析仅限于真菌孢子最流行的时期（6月至10月中旬）。采用非参数回归时间序列方法来评估控制季节性、星期和气象因素的关联。还评估了研究结果对将花粉和空气污染纳入模型的敏感性。结果：在0-14岁儿童中，与真菌孢子浓度变化相关的急诊室就诊次数和住院次数增加的相对风险从下到上四分位数分别为1.06 （95% CI 0.94至1.18）和1.07（0.97至1.19）。添加花粉或空气污染物对观察到的关联影响不大。一些单独的孢子分类群，特别是互生孢子、表生孢子、Agrocybe、Mildews，以及彩色和无色担子孢子和子囊孢子，与哮喘急诊和住院人数的增加有关，尽管这些估计的准确性很低。在成人中没有发现相关的证据。结论：真菌孢子浓度可能引发或加剧儿童哮喘发作，导致儿童去急诊室和急诊住院。这些发现不太可能是由于其他环境因素的混杂。这些关联与从类似设计的研究中观察到的环境空气污染的关联相当。
Background: Outdoor aeroallergens are one of a number of environmental factors thought to precipitate asthma exacerbations.Aims: To investigate the short term associations between daily fungal spore concentrations and indicators of daily asthma exacerbations in a large urban population.Methods: Daily counts of visits for asthma to family physicians and hospital accident and emergency (A&E) departments and emergency hospital admissions in London 1992-93 were compiled. Daily concentrations of fungal spores ( 30 species), daily average temperature, humidity, and concentrations of pollen and outdoor air pollution were also compiled. The analysis was restricted to the period when fungal spores were most prevalent ( June to mid October). Non-parametric regression time series methods were used to assess associations controlling for seasonality, day of week, and meteorological factors. The sensitivity of the findings to the inclusion of pollen and air pollution into the models was also assessed.Results: In children aged 0-14 years the relative risks for increases in the number of A&E visits and hospital admissions associated with changes in fungal spore concentrations from the lower to upper quartiles were 1.06 (95% CI 0.94 to 1.18) and 1.07 (0.97 to 1.19) respectively. The addition of pollen or air pollutants had little impact on the observed associations. A number of individual spore taxa, in particular Alternaria, Epicoccum, Agrocybe, Mildews, and both coloured and colourless Basidiospores and Ascospores, were associated with increases in the number of emergency visits and hospital admissions for asthma, although the precision of these estimates were low. No evidence was found for associations in adults.Conclusions: Fungal spore concentrations may provoke or exacerbate asthma attacks in children resulting in visits to A&E departments and emergency hospital admissions. These findings were unlikely to be due to confounding by other environmental factors. The associations were comparable to those observed for ambient air pollution from similarly designed studies.