Environmental effects on acute exacerbations of respiratory diseases: A real-world big data study.
Environmental effects on acute exacerbations of respiratory diseases: A real-world big data study.
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DOI：
10.1016/j.scitotenv.2021.150352
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发表时间：
2022-02-01
期刊：
影响因子：
--
通讯作者：
Hu H
中科院分区：
文献类型：
--
作者：
Fishe J;Zheng Y;Lyu T;Bian J;Hu H
BackgroundThe effects of weather periods, race/ethnicity, and sex on environmental triggers for respiratory exacerbations are not well understood. This study linked the OneFlorida network (~15 million patients) with an external exposome database to analyze environmental triggers for asthma, bronchitis, and COPD exacerbations while accounting for seasonality, sex, and race/ethnicity.MethodsThis is a case-crossover study of OneFlorida database from 2012 to 2017 examining associations of asthma, bronchitis, and COPD exacerbations with exposures to heat index, PM 2.5 and O 3. We spatiotemporally linked exposures using patients' residential addresses to generate average exposures during hazard and control periods, with each case serving as its own control. We considered age, sex, race/ethnicity, and neighborhood deprivation index as potential effect modifiers in conditional logistic regression models.ResultsA total of 1,148,506 exacerbations among 533,446 patients were included.Across all three conditions, hotter heat indices conferred increasing exacerbation odds, except during November to March, where the opposite was seen. There were significant differences when stratified by race/ethnicity (e.g., for asthma in April, May, and October, heat index quartile 4, odds were 1.49 (95% confidence interval (CI) 1.42–1.57) for Non-Hispanic Blacks and 2.04 (95% CI 1.92–2.17) for Hispanics compared to 1.27 (95% CI 1.19–1.36) for Non-Hispanic Whites). Pediatric patients' odds of asthma and bronchitis exacerbations were significantly lower than adults in certain circumstances (e.g., for asthma during June – September, pediatric odds 0.71 (95% CI 0.68-0.74) and adult odds 0.82 (95% CI 0.79-0.85) for the highest quartile of PM 2.5).ConclusionThis study of acute exacerbations of asthma, bronchitis, and COPD found exacerbation risk after exposure to heat index, PM 2.5 and O 3 varies by weather period, age, and race/ethnicity. Future work can build upon these results to alert vulnerable populations to exacerbation triggers.
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影响因子：
5.7
作者：
Ioachimescu, Octavian C.;Desai, Nikita S.
通讯作者：
Desai, Nikita S.
DOI：
10.3200/aeoh.58.2.111-118
发表时间：
2003-02-01
期刊：
ARCHIVES OF ENVIRONMENTAL HEALTH
影响因子：
--
作者：
Brender, JD;Pichette, JL;Holt, M
通讯作者：
Holt, M
DOI：
10.1164/ajrccm/148.1.10
发表时间：
1993-07-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
GOLD, DR;ROTNITZKY, A;DOCKERY, DW
通讯作者：
DOCKERY, DW
影响因子：
8.9
作者：
Li, Li;Yang, Jun;Guo, Yuming
通讯作者：
Guo, Yuming
影响因子：
10.4
作者：
Lipsett M;Hurley S;Ostro B
通讯作者：
Ostro B