Prediction of asthma exacerbations among children through integrating air pollution, upper atmosphere, and school health surveillances
Prediction of asthma exacerbations among children through integrating air pollution, upper atmosphere, and school health surveillances
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DOI：
10.2500/aap.2013.34.3629
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发表时间：
2013-01-01
影响因子：
2.8
通讯作者：
El Afandi, Gamal Salah
中科院分区：
文献类型：
--
作者：
Jayawardene, Wasantha Parakrama;YoussefAgha, Ahmed Hassan;El Afandi, Gamal Salah
气候因素和空气污染是预测儿童哮喘恶化的重要因素。这项研究旨在确定小学生哮喘恶化与日常高层大气观测(温度、相对湿度、露点和混合比)和日常空气污染(颗粒物、二氧化硫、二氧化氮、一氧化碳和臭氧)的综合影响之间是否存在关系，如果存在，则使用数学模型预测儿童哮喘恶化。采用生态学研究设计，对宾夕法尼亚州49个县的168,825名小学在校学生的健康记录进行了分析。代表哮喘恶化的数据最初由学校护士记录为在特定日期的诊所就诊期间对学生进行的治疗类型。获得了从地面到850毫巴气压水平的每日高空大气测量数据和空气污染数据。一个广义估计方程模型被用来预测48例哮喘恶化的发生，这是2008-2010年间的日平均值。学龄儿童中哮喘发病率最高的是秋季，其次是夏季、春季和冬季。高层大气温度、露点、混合比和六种空气污染物及其相互作用预测了儿童哮喘恶化的可能性。随着时间的推移，监测高层大气观测数据和空气污染物是预测小学生哮喘加重增加的可靠手段。这样的预测可以帮助家长和学校官员实施有效的预防措施。
Climatic factors and air pollution are important in predicting asthma exacerbations among children. This study was designed to determine if a relationship exists between asthma exacerbations among elementary school children and the combined effect of daily upper atmosphere observations (temperature, relative humidity, dew point, and mixing ratio) and daily air pollution (particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone) and, if so, to predict asthma exacerbations among children using a mathematical model. Using an ecological study design, school health records of 168,825 students in elementary schools enrolled in "Health eTools for Schools" within 49 Pennsylvania counties were analyzed. Data representing asthma exacerbations were originally recorded by school nurses as the type of treatment given to a student during a clinic visit on a particular day. Daily upper atmosphere measurements from ground level to the 850-mb pressure level and air pollution measurements were obtained. A generalized estimating equation model was used to predict the occurrence of > 48 asthma exacerbations, the daily mean for 2008-2010. The greatest occurrence of asthma among school children was in the fall, followed by summer, spring, and winter. Upper atmosphere temperature, dew point, mixing ratio, and six air pollutants as well as their interactions predicted the probability of asthma exacerbations occurring among children. Monitoring of upper atmosphere observation data and air pollutants over time can be a reliable means for predicting increases of asthma exacerbations among elementary school children. Such predictions could help parents and school officials implement effective precautionary measures.