The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002-2012.
The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002-2012.
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DOI：
10.1186/s12940-015-0057-0
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发表时间：
2015-08-27
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影响因子：
--
通讯作者：
Matte TD
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作者：
Ito K;Weinberger KR;Robinson GS;Sheffield PE;Lall R;Mathes R;Ross Z;Kinney PL;Matte TD
许多类型的树木花粉会引发季节性过敏性疾病，但它们对过敏和哮喘发病率的人群水平影响尚未明确，这可能是由于缺乏能够分析多日影响的每日花粉数据的长期记录。因此，我们本研究的目的是确定个别春树花粉类型对非处方过敏药物销售和哮喘急诊科 (ED) 就诊的影响。 3 月 1 日至 6 月 10 日期间，根据纽约市患者的主诉或诊断代码，分析了在纽约州阿蒙克测量的 9 个临床相关的春树花粉属（榆树、杨树、枫树、桦树、山毛榉、白蜡木、悬铃木/伦敦梧桐、橡树和山核桃）与非处方过敏药物销售和每日哮喘综合征急诊就诊的关系。 2002-2012。使用调整时间趋势、星期几、天气和空气污染的分布式滞后泊松时间序列模型来估计花粉对结果的多日影响（药物销售和急诊就诊分别为 0-3 天和 0-7 天）。对于哮喘综合征急诊就诊，还分析了年龄组。平均峰值日期和花粉与结果之间第 10 至 90 个百分位持续时间的逐年变化也通过 Spearman 等级相关性进行了检查。仲春花粉类型（枫树、桦树、山毛榉、白蜡树、橡树和悬铃木/伦敦梧桐）与这两种结果显示出最强的显着相关性，每增加 0 到 98 个百分位花粉，累积比率高达 2.0（例如，1.9 [95 % CI：1.7、2.1] 和 1.7 [95 % CI：1.5， 1.9]对于药物销售和急诊就诊， 分别为灰）。哮喘综合征急诊就诊的滞后关联比药物销售的滞后关联更长。儿童中的相关性最强（5-17 岁；例如，灰分每增加 0 至 98 个百分位，累积比率为 2.6 [95% CI：2.1，3.1]）。其中一些仲春花粉类型的平均峰值日期和持续时间也与结果相关。仲春时节树木花粉达到高峰，对过敏和哮喘恶化有显着影响，尤其是对儿童。鉴于这些花粉高峰出现的时间窗口很窄，应该制定预测和减少过敏/哮喘恶化的公共卫生和临床方法。本文的在线版本 (doi:10.1186/s12940-015-0057-0) 包含补充材料，可供授权用户使用。
Many types of tree pollen trigger seasonal allergic illness, but their population-level impacts on allergy and asthma morbidity are not well established, likely due to the paucity of long records of daily pollen data that allow analysis of multi-day effects. Our objective in this study was therefore to determine the impacts of individual spring tree pollen types on over-the-counter allergy medication sales and asthma emergency department (ED) visits. Nine clinically-relevant spring tree pollen genera (elm, poplar, maple, birch, beech, ash, sycamore/London planetree, oak, and hickory) measured in Armonk, NY, were analyzed for their associations with over-the-counter allergy medication sales and daily asthma syndrome ED visits from patients’ chief complaints or diagnosis codes in New York City during March 1st through June 10th, 2002-2012. Multi-day impacts of pollen on the outcomes (0-3 days and 0-7 days for the medication sales and ED visits, respectively) were estimated using a distributed lag Poisson time-series model adjusting for temporal trends, day-of-week, weather, and air pollution. For asthma syndrome ED visits, age groups were also analyzed. Year-to-year variation in the average peak dates and the 10th-to-90th percentile duration between pollen and the outcomes were also examined with Spearman’s rank correlation. Mid-spring pollen types (maple, birch, beech, ash, oak, and sycamore/London planetree) showed the strongest significant associations with both outcomes, with cumulative rate ratios up to 2.0 per 0-to-98th percentile pollen increase (e.g., 1.9 [95 % CI: 1.7, 2.1] and 1.7 [95 % CI: 1.5, 1.9] for the medication sales and ED visits, respectively, for ash). Lagged associations were longer for asthma syndrome ED visits than for the medication sales. Associations were strongest in children (ages 5-17; e.g., a cumulative rate ratio of 2.6 [95 % CI: 2.1, 3.1] per 0-to-98th percentile increase in ash). The average peak dates and durations of some of these mid-spring pollen types were also associated with those of the outcomes. Tree pollen peaking in mid-spring exhibit substantive impacts on allergy, and asthma exacerbations, particularly in children. Given the narrow time window of these pollen peak occurrences, public health and clinical approaches to anticipate and reduce allergy/asthma exacerbation should be developed. The online version of this article (doi:10.1186/s12940-015-0057-0) contains supplementary material, which is available to authorized users.