Fungal and other spore counts as predictors of admissions for asthma in the Trent region
Fungal and other spore counts as predictors of admissions for asthma in the Trent region
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DOI：
10.1136/oem.57.11.786
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发表时间：
2000-11-01
影响因子：
4.9
通讯作者：
Millington, W
中科院分区：
文献类型：
--
作者：
Newson, R;Strachan, D;Millington, W
目的：空气中真菌和其他孢子在引发哮喘发作中的重要性尚不确定。小组研究得出的证据表明，室外孢子数量与哮喘严重程度之间存在联系。目前还没有基于人群的时间序列研究，将室外暴露于孢子与哮喘发作发生率联系起来。方法：结果是1987- 1994年期间，英格兰Trent地区儿童和成人因哮喘住院的2002天。预测因子为德比市容积诱捕器25个孢子类群的日计数。通过对数线性自回归模型调整每周、季节性和长期趋势的哮喘入院率。同时还检测了哮喘流行6天的孢子计数。结果：当单个分类群的孢子数作为定量变量进行分析时，在5%的水平上，两个正相关和两个负相关（可能的100个）显著。当孢子计数在第90百分位数上二分时，在5%的水平上，1个负相关和8个正相关（100个）显着。所有显著的正相关都与儿童入院有关，但没有涉及孢子总数。然而，在6个流行日中，有4天孢子总数超过第90百分位（优势比（OR） 9.92, 95%可信区间（95% CI） 1.41 ~ 109.84），但在霉菌总数高的343天中，只有4天发生了流行。结论：有一些证据表明，哮喘的特殊住院率往往发生在霉菌孢子总数高的日子，但没有特定的分类群一致涉及。预测能力不足以支持公共预警系统。
Objectives-The importance of airborne fungal and other spores in provoking asthma attacks is uncertain. Panel studies have generated evidence that suggests a link between outdoor spore counts and severity of asthma. There have been no population based time series studies relating outdoor exposure to spores with incidence of attacks of asthma.Methods-Outcomes were hospital admissions for asthma on 2002 days during 1987-94, for children and adults in the Trent region of England. Predictors were daily counts of 25 spore taxa from volumetric traps in Derby on the same and previous day. Admissions for asthma were adjusted for weekly, seasonal, and longer term trends by log linear autoregressive models. Spore counts on 6 days of asthma epidemics were also examined.Results-When spore counts for individual taxa were analysed as quantitative variables, two positive and two negative correlations (out of a possible 100) were significant at the 5% level. When spore counts were dichotomised at the 90th percentile, one negative and eight positive correlations (out of 100) were significant at the 5% level. All significantly positive associations related to admissions among children, but none involved the total spore count. However, total spores were above the 90th percentile on four of the six epidemic days (odds ratio (OR) 9.92, 95% confidence interval (95% CI) 1.41 to 109.84), but epidemics occurred on only four of 343 days with high total moulds.Conclusions There was some evidence that exceptional rates of admission for asthma tend to occur on days with high total mould spore counts, but no specific taxon was consistently implicated. The predictive power was insufficient to support a public warning system.