Spatial Heterogeneity of the Respiratory Health Impacts of Wildfire Smoke PM2.5 in California.
Spatial Heterogeneity of the Respiratory Health Impacts of Wildfire Smoke PM2.5 in California.
复制标题
加州野火烟雾 PM2.5 对呼吸系统健康影响的空间异质性。
作者：
Do,V;Chen,C;Benmarhnia,T;Casey,JA
野火烟雾细颗粒物（PM2.5）是一个日益严重的公共卫生威胁，因为野火事件在气候变化下变得更加普遍和激烈，特别是在美国西部。评估野火PM2.5暴露与健康之间关系的研究通常总结了研究区域的影响。然而，对野火PM2.5的健康反应可能在空间上有所不同。我们评估了与短期暴露于野火PM2.5相关的空间变化的急性呼吸道护理利用风险，并探讨了可能导致空间异质性的社区特征。使用集合建模的每日野火PM2.5，我们定义野火烟雾日具有野火特定PM2.5浓度≥15 μg/m3。我们纳入了1，396个加州邮政编码列表区（ZCTA）和15个人口普查衍生社区特征的每日呼吸急诊科就诊和计划外住院。采用病例交叉设计和条件logistic回归，我们观察到在州一级野火烟雾日呼吸道急性护理利用率增加（比值比[OR] = 1.06，95%置信区间[CI]：1.05，1.07）。在各个空气盆地中，OR值范围为0.88至1.57，圣地亚哥的影响估计值最高。社区内匹配设计和空间贝叶斯分层模型也揭示了ZCTA水平比率差异的空间异质性。例如，黑人或太平洋岛民比例较高的社区具有更强的野火PM2.5结果关系，而更多的空调和树冠减弱了相关性。我们发现野火烟雾相关的健康影响在空气流域，县和ZCTAs之间存在重要的异质性，我们确定了脆弱社区的特征，为指导政策制定和资源分配提供了证据。
Wildfire smoke fine particles (PM2.5) are a growing public health threat as wildfire events become more common and intense under climate change, especially in the Western United States. Studies assessing the association between wildfire PM2.5exposure and health typically summarize the effects over the study area. However, health responses to wildfire PM2.5may vary spatially. We evaluated spatially‐varying respiratory acute care utilization risks associated with short‐term exposure to wildfire PM2.5and explored community characteristics possibly driving spatial heterogeneity. Using ensemble‐modeled daily wildfire PM2.5, we defined a wildfire smoke day to have wildfire‐specific PM2.5concentration ≥15 μg/m3. We included daily respiratory emergency department visits and unplanned hospitalizations in 1,396 California ZIP Code Tabulation Areas (ZCTAs) and 15 census‐derived community characteristics. Employing a case‐crossover design and conditional logistic regression, we observed increased odds of respiratory acute care utilization on wildfire smoke days at the state level (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.05, 1.07). Across air basins, ORs ranged from 0.88 to 1.57, with the highest effect estimate in San Diego. A within‐community matching design and spatial Bayesian hierarchical model also revealed spatial heterogeneity in ZCTA‐level rate differences. For example, communities with a higher percentage of Black or Pacific Islander residents had stronger wildfire PM2.5‐outcome relationships, while more air conditioning and tree canopy attenuated associations. We found an important heterogeneity in wildfire smoke‐related health impacts across air basins, counties, and ZCTAs, and we identified characteristics of vulnerable communities, providing evidence to guide policy development and resource allocation.