City-Specific Air Quality Warnings for Improved Asthma Self-Management
City-Specific Air Quality Warnings for Improved Asthma Self-Management
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DOI：
10.1016/j.amepre.2019.03.022
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发表时间：
2019-08-01
影响因子：
5.5
通讯作者：
Persse, David E.
中科院分区：
文献类型：
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作者：
Raun, Loren H.;Ensor, Katherine B.;Persse, David E.
本研究提出了一个框架，用于识别与标准污染物浓度升高相关的哮喘发作“高危”日，使用当地信息在浓度与环境保护局空气质量指数（AQI）警告不同的日子向公民发出警告。考虑到污染物的独特混合物和特定城市的健康数据的研究为哮喘自我管理提供了额外的信息。该框架应用于德克萨斯州休斯顿的空气污染和哮喘数据，以确定补充预警日。方法：建立了一个四步框架，以确定污染物水平与基线相比有意义增加哮喘发作风险的天数。使用病例交叉研究设计和条件逻辑回归分析了德克萨斯州休斯顿18542例救护车治疗哮喘发作与空气污染物浓度之间的历史关联（2004-2016；2018年分析）。污染和哮喘发作之间历史高度关联的日子被确定为补充预警日。结果：前3天8小时最大臭氧浓度为66.6 ppb，当日24小时最大二氧化氮浓度为19.3 ppb的天数，相对危险度比基线高15%；高于这些水平的浓度分别使风险增加15% （RR=1.15, 95% CI=1.14, 1.16）和30% （RR=1.30, 95% CI=1.29, 1.32）。这些警告每年比美国空气质量指数的警告多出12%的天数。结论：休斯顿使用这个框架来确定补充空气质量警告，以改善哮喘自我管理。补充天数反映风险低于国家环境空气质量标准和连续空气质量差的天数，与AQI不同。(C) 2019美国预防医学杂志。Elsevier Inc.出版。
Introduction: This study presents a framework for identifying "high-risk" days for asthma attacks associated with elevated concentrations of criteria pollutants using local information to warn citizens on days when the concentrations differ from Environmental Protection Agency Air Quality Index (AQI) warnings. Studies that consider the unique mixture of pollutants and the health data specific to a city provide additional information for asthma self-management. This framework is applied to air pollution and asthma data to identify supplemental warning days in Houston, Texas.Methods: A four-step framework was established to identify days with pollutant levels that pose meaningful increased risk for asthma attacks compared with baseline. Historical associations between 18,542 ambulance-treated asthma attacks and air pollutant concentrations in Houston, Texas (2004-2016; analyzed in 2018), were analyzed using a case-crossover study design with conditional logistic regression. Days with historically high associations between pollution and asthma attacks were identified as supplemental warning days.Results: Days with 8-hour maximum ozone >66.6 parts per billion for the 3 previous days and same-day 24-hour nitrogen dioxide >19.3 parts per billion pose an RR of 15% above baseline; concentrations above these levels pose an increased risk of 15% (RR=1.15, 95% CI=1.14, 1.16) and 30% (RR=1.30, 95% CI=1.29, 1.32), respectively. These warnings add an additional 12% days per year over the AQI warnings.Conclusions: Houston uses this framework to identify supplemental air quality warnings to improve asthma self-management. Supplemental days reflect risk lower than the National Ambient Air Quality Standards and consecutive poor air quality days, differing from the AQI. (C) 2019 American Journal of Preventive Medicine. Published by Elsevier Inc.