The relationship of respiratory and cardiovascular hospital admissions to the southern California wildfires of 2003.
The relationship of respiratory and cardiovascular hospital admissions to the southern California wildfires of 2003.
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DOI：
10.1136/oem.2008.041376
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发表时间：
2009-03
影响因子：
4.9
通讯作者：
Gillen DL
中科院分区：
文献类型：
--
作者：
Delfino RJ;Brummel S;Wu J;Stern H;Ostro B;Lipsett M;Winer A;Street DH;Zhang L;Tjoa T;Gillen DL
关于野火对公共卫生影响的信息有限。对 2003 年 10 月南加州灾难性野火期间心肺入院人数 (n = 40 856) 与野火相关颗粒物 (PM2.5) 的关系进行了评估。邮政编码级别的 PM2.5 浓度是根据测量的 PM2.5、消光、气象条件和分辨率为 250 m 的 MODIS 卫星图像的烟雾信息进行空间插值来估计的。泊松数据的广义估计方程用于评估每日入院人数与 PM2.5 之间的关系，并根据天气、真菌孢子（与哮喘相关）、周末、邮政编码级别的人口和社会人口统计数据进行调整。火灾期间两天平均 PM2.5 与呼吸道入院的关联性比火灾发生前或火灾后更强。与野火前时期的 PM2.5 相比，浓烟条件下 PM2.5 平均增加 70 μg/m3，导致哮喘入院人数增加 34%。与野火相关的 PM2.5 关联性最强的是 65-99 岁人群（每 10 μg/m3 PM2.5 增加 10.1%，95% CI 3.0% 至 17.8%）和 0-4 岁人群（8.3%，95% CI 2.2% 至 14.9%），其次是 20-64 岁人群（4.1%，95% CI） 20.5％至9.0％）。尽管火灾后 5-18 岁儿童的入院率显着增加，但 PM2.5 与哮喘之间没有关联。与野火相关的 PM2.5 每增加 10 μg/m3，所有年龄段的急性支气管炎入院人数增加 9.6%（95% CI 1.8% 至 17.9%），20-64 岁慢性阻塞性肺病入院人数增加 6.9%（95% CI 0.9% 至 13.1%），5-18 岁肺炎入院人数增加 6.4%（95% CI） CI 21.0% 至 14.2%）。火灾后，急性支气管炎和肺炎的入院人数也有所增加。有限的证据表明，与野火相关的 PM2.5 对心血管入院的影响很小。与野火相关的 PM2.5 导致呼吸道疾病住院人数增加，尤其是哮喘患者，这表明需要采取更好的预防措施来降低弱势群体的发病率。
There is limited information on the public health impact of wildfires. The relationship of cardiorespiratory hospital admissions (n = 40 856) to wildfire-related particulate matter (PM2.5) during catastrophic wildfires in southern California in October 2003 was evaluated. Zip code level PM2.5 concentrations were estimated using spatial interpolations from measured PM2.5, light extinction, meteorological conditions, and smoke information from MODIS satellite images at 250 m resolution. Generalised estimating equations for Poisson data were used to assess the relationship between daily admissions and PM2.5, adjusted for weather, fungal spores (associated with asthma), weekend, zip code-level population and sociodemographics. Associations of 2-day average PM2.5 with respiratory admissions were stronger during than before or after the fires. Average increases of 70 μg/m3 PM2.5 during heavy smoke conditions compared with PM2.5 in the pre-wildfire period were associated with 34% increases in asthma admissions. The strongest wildfire-related PM2.5 associations were for people ages 65– 99 years (10.1% increase per 10 μg/m3 PM2.5, 95% CI 3.0% to 17.8%) and ages 0–4 years (8.3%, 95% CI 2.2% to 14.9%) followed by ages 20–64 years (4.1%, 95% CI 20.5% to 9.0%). There were no PM2.5–asthma associations in children ages 5–18 years, although their admission rates significantly increased after the fires. Per 10 μg/m3 wildfire-related PM2.5, acute bronchitis admissions across all ages increased by 9.6% (95% CI 1.8% to 17.9%), chronic obstructive pulmonary disease admissions for ages 20–64 years by 6.9% (95% CI 0.9% to 13.1%), and pneumonia admissions for ages 5–18 years by 6.4% (95% CI 21.0% to 14.2%). Acute bronchitis and pneumonia admissions also increased after the fires. There was limited evidence of a small impact of wildfire-related PM2.5 on cardiovascular admissions. Wildfire-related PM2.5 led to increased respiratory hospital admissions, especially asthma, suggesting that better preventive measures are required to reduce morbidity among vulnerable populations.
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