Wildfire smoke exposure and emergency department visits for headache: A case-crossover analysis in California, 2006-2020.
Wildfire smoke exposure and emergency department visits for headache: A case-crossover analysis in California, 2006-2020.
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野火烟雾曝光和急诊科的头痛访问：2006 - 2020年加利福尼亚州的病例分解分析。
作者：
评估短期暴露于总的细颗粒物-lt；2.5μm(PM2.5)和特定于野火的PM2.5与头痛急诊科就诊的相关性。已有研究报告了PM2.5暴露与头痛风险之间的关联。随着气候变化导致野火季节更长、更激烈，野火PM2.5可能会导致更频繁的头痛。我们的研究包括2006年至2020年大型商业和医疗保险优势索赔数据库的成年加州成员(年龄≥18岁)。我们确定了急诊科就诊的原发头痛障碍(亚型：紧张型头痛、偏头痛、丛集性头痛和其他原发头痛)。索赔包括成员的年龄、性别和居住邮政编码。我们将每日总体和野火特定的PM2.5与住宅邮政编码联系起来，并进行了时间分层的病例交叉分析，考虑了7天平均PM2.5浓度，首先是原发头痛疾病的综合，然后是头痛的亚型。在9898名独特的个体中，我们确定了13,623名患有原发性头痛障碍的急诊科患者。偏头痛是最常见的头痛(N=5534/13,623[47.6%])，其次是“其他”主要头痛(N=6489/13,623[40.6%])。对于所有原发头痛的ED诊断，我们观察到7天平均野火PM2.5(优势比[OR]1.17，每10μg/立方米增加95%可信区间[CI]0.95-1.44)与急性型头痛(OR1.42，95%CI0.91-2.22)、“其他”原发头痛(OR1.40，95%CI0.96-2.05)和丛集性头痛(OR1.29，95%可信区间0.71-2.35)，尽管这些发现在传统的零假设检验下没有统计学意义。总体而言，PM2.5与紧张型头痛(OR1.29，95%可信区间1.03-1.62)有关，但与偏头痛、丛集性头痛或其他原发头痛无关。尽管这些结果并不准确，但这些结果表明，短期接触野火PM2.5可能与急诊室因头痛就诊有关。患者、医疗保健提供者和系统可能需要对野火过后和空气质量差的日子中与头痛相关的更多医疗需求做出反应。
To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM2.5) and wildfire-specific PM2.5 with emergency department (ED) visits for headache. Studies have reported associations between PM2.5 exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM2.5 may contribute to more frequent headaches. Our study included adult Californian members (aged ≥18 years) of a large de-identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension-type headache, migraine headache, cluster headache, and “other” primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire-specific PM2.5 to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM2.5 concentrations, first for primary headache disorders combined, and then by headache subtype. Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (N = 5534/13,623 [47.6%]) followed by “other” primary headache (N = 6489/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7-day average wildfire PM2.5 (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95–1.44 per 10 μg/m3 increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM2.5 for tension-type headache (OR 1.42, 95% CI 0.91–2.22), “other” primary headache (OR 1.40, 95% CI 0.96–2.05), and cluster headache (OR 1.29, 95% CI 0.71–2.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM2.5 was associated with tension-type headache (OR 1.29, 95% CI 1.03–1.62), but not migraine, cluster, or “other” primary headaches. Although imprecise, these results suggest short-term wildfire PM2.5 exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache-related healthcare needs in the wake of wildfires and on poor air quality days.
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影响因子：
4
作者：
Armstrong BG;Gasparrini A;Tobias A
通讯作者：
Tobias A
影响因子：
11.8
作者：
Achilleos S;Kioumourtzoglou MA;Wu CD;Schwartz JD;Koutrakis P;Papatheodorou SI
通讯作者：
Papatheodorou SI
DOI：
10.3390/ijerph120504697
发表时间：
2015-05-01
影响因子：
--
作者：
Chen, Chih-Cheng;Tsai, Shang-Shyue;Yang, Chun-Yuh
通讯作者：
Yang, Chun-Yuh
影响因子：
4.8
作者：
Gan, Ryan W.;Ford, Bonne;Magzamen, Sheryl
通讯作者：
Magzamen, Sheryl
2016年麦克默里堡野火（Fort McMurray Wildfire）的3.5岁的学生意外增加了11-19岁的学生的心理健康症状：9,376次调查的发现。
影响因子：
4.7
作者：
Brown MRG;Pazderka H;Agyapong VIO;Greenshaw AJ;Cribben I;Brett-MacLean P;Drolet J;McDonald-Harker CB;Omeje J;Lee B;Mankowsi M;Noble S;Kitching DT;Silverstone PH
通讯作者：
Silverstone PH