Effects of air pollution on moderate and severe asthma exacerbations
Effects of air pollution on moderate and severe asthma exacerbations
复制标题
DOI：
10.1080/02770903.2019.1611844
复制
发表时间：
2020-08
影响因子：
1.9
通讯作者：
Seungwoo Shin;D. Bae;Choon-Sik Park;Jong-Uk Lee;R. Kim;Sung Roul Kim;H. Chang;Jong Sook Park
中科院分区：
文献类型：
--
作者：
Seungwoo Shin;D. Bae;Choon-Sik Park;Jong-Uk Lee;R. Kim;Sung Roul Kim;H. Chang;Jong Sook Park
摘要背景：很少有研究评估空气污染水平对病情恶化的影响。因此，我们比较了空气污染物水平对中度和重度恶化带来的相对风险。方法：对韩国一家三级医院2005年至2015年间143例成人哮喘患者的618例哮喘发作进行回顾性分析。距离每个患者家最近的位置的空气污染GPS数据是从国家环境监测站获得的。在哮喘发作当天(T-0)和发病前3天(T-1-T-3)，采用时间趋势对称、双向、病例交叉设计的条件Logistic回归模型，评价空气污染物对哮喘发作的相对影响。结果：总的哮喘加重与夏季和冬季的臭氧水平(OR：1.012[1.003~1.02]和1.009[1.003~1.016])、春季和夏季的二氧化硫水平(OR：1.009[1~1.018]和1.02[1.006~1.035])和冬季的NO_2水平(OR：1.007[1.003~1.011])有关。臭氧浓度与天气恶化的时间关系分析表明，63.2%的夏季暴发事件发生在T-1上的臭氧浓度显著高于对照日，而51%的冬季暴发事件发生在冬季。重度和中度加重与冬季(OR：1.012[1.003-1.02]vs.1.01[0.999-1.021]，p>；0.05)和夏季(OR：1.006[1.002-1.009]vs.1.009[1.003-1.016]，p>；0.05)的臭氧水平相似。结论：哮喘的加重可能与夏季和冬季臭氧、SO2和NO2水平的季节性升高有关，中度和重度哮喘发作的相对风险相似。
Abstract Background: Few studies have evaluated the impact of air pollution levels on the severity of exacerbations. Thus, we compared the relative risks posed by air pollutant levels on moderate and severe exacerbations. Methods: Exacerbation episodes of 618 from 143 adult asthmatics were retrospectively collected between 2005 and 2015 in a tertiary hospital of Korea. Air pollution GPS data for the location closest to each patient’s home were obtained from the national ambient monitoring station. The relative impacts of air pollutants on asthma exacerbations were evaluated via a time-trend controlled symmetrical, bidirectional, case-crossover design using conditional logistic regression models on the day of the exacerbation (T-0) and up to 3 days before the exacerbation (T-1–T-3). Results: Overall asthma exacerbation were associated with O3 levels in summer and winter (OR: 1.012[1.003–1.02] and 1.009[1.003–1.016]), SO2 levels in spring and summer (OR: 1.009[1–1.018] and 1.02[1.006–1.035]) and NO2 levels in winter (OR: 1.007[1.003–1.011]). Analyses of the temporal relationship between O3 concentrations and exacerbations demonstrated that 63.2% of episodes in the summer occurred when the O3 concentrations on T-1 were significantly higher than those on control days, while 51% of exacerbation episodes in the winter occurred. Severe and moderate exacerbations were similarly associated with O3 levels in winter (OR: 1.012 [1.003–1.02] vs. 1.01 [0.999–1.021], p > 0.05) and in summer (OR: 1.006 [1.002–1.009] vs. 1.009 [1.003–1.016], p > 0.05). Conclusions: Asthma exacerbations may be associated with the seasonal elevation of O3, SO2 and NO2 levels in summer and winter with the similar relative risk between moderate and severe exacerbations.