Spatio-temporal associations of air pollutant concentrations, GP respiratory consultations and respiratory inhaler prescriptions: a 5-year study of primary care in the borough of Lambeth, South London.
Spatio-temporal associations of air pollutant concentrations, GP respiratory consultations and respiratory inhaler prescriptions: a 5-year study of primary care in the borough of Lambeth, South London.
复制标题
DOI：
10.1186/s12940-021-00730-1
复制
发表时间：
2021-05-07
期刊：
影响因子：
--
通讯作者：
STEAM project research group
中科院分区：
文献类型：
--
作者：
Ashworth M;Analitis A;Whitney D;Samoli E;Zafeiratou S;Atkinson R;Dimakopoulou K;Beavers S;Schwartz J;Katsouyanni K;STEAM project research group
尽管户外空气污染暴露与死亡率和入院人数之间的关系已经得到了很好的证实，但以前很少有研究报告初级保健临床和处方数据。我们评估了短期和长期污染物暴露与全科医生呼吸系统咨询和吸入器处方之间的关系。2009-2013年的每日初级保健数据来自Lambeth Datanet(LDN)，这是一个匿名数据集，包含在伦敦南部市中心的Lambeth区全科诊所注册的所有患者(120万)的编码数据。建立呼吸咨询和吸入器处方按日计数和居住地低超输出量面积(LSOA)。我们开发了预测每LSOA每日PM2.5、PM10、NO2和O3的模型。我们使用时空混合效应零膨胀负二项模型来研究污染物暴露对事件数量的同时的短期和长期影响。研究期内大气中NO_2、PM_(10)、PM_(2.5)和O_3的平均浓度分别为50·7、21·2、15·6和49·9 μg/m~3，除NO_2外，其他污染物的时间变异性比空间变异性大得多。在短期暴露于PM10、NO2和PM2.5之后，就诊和吸入器处方的数量被发现增加，特别是儿童接触PM10，这与每天呼吸咨询增加3.4%和吸入器处方增加0.8%有关，每增加PM10四分位数范围(IQR)。在对每周平均暴露进行调整后，相关性进一步增加，每周平均PM10暴露分别上升至6.1%和1.2%。相反，短期内臭氧暴露的增加与呼吸咨询次数的减少有关。长期接触PM10、PM2.5和NO2与呼吸咨询次数之间没有发现关联。长期接触NO2仅与预防性吸入器处方的增加(8%)相关。我们发现，在暴露于NO2、PM10和PM2.5的短期增加之后，每日全科医生呼吸咨询和吸入器处方的数量增加。这些关联在儿童中更为明显，并至少持续一周。长期接触NO2和预防性吸入器处方的相关性表明，慢性呼吸道发病率可能会增加。
Although the associations of outdoor air pollution exposure with mortality and hospital admissions are well established, few previous studies have reported on primary care clinical and prescribing data. We assessed the associations of short and long-term pollutant exposures with General Practitioner respiratory consultations and inhaler prescriptions. Daily primary care data, for 2009–2013, were obtained from Lambeth DataNet (LDN), an anonymised dataset containing coded data from all patients (1.2 million) registered at general practices in Lambeth, an inner-city south London borough. Counts of respiratory consultations and inhaler prescriptions by day and Lower Super Output Area (LSOA) of residence were constructed. We developed models for predicting daily PM2.5, PM10, NO2 and O3 per LSOA. We used spatio-temporal mixed effects zero inflated negative binomial models to investigate the simultaneous short- and long-term effects of exposure to pollutants on the number of events. The mean concentrations of NO2, PM10, PM2.5 and O3 over the study period were 50.7, 21.2, 15.6, and 49.9 μg/m3 respectively, with all pollutants except NO2 having much larger temporal rather than spatial variability. Following short-term exposure increases to PM10, NO2 and PM2.5 the number of consultations and inhaler prescriptions were found to increase, especially for PM10 exposure in children which was associated with increases in daily respiratory consultations of 3.4% and inhaler prescriptions of 0.8%, per PM10 interquartile range (IQR) increase. Associations further increased after adjustment for weekly average exposures, rising to 6.1 and 1.2%, respectively, for weekly average PM10 exposure. In contrast, a short-term increase in O3 exposure was associated with decreased number of respiratory consultations. No association was found between long-term exposures to PM10, PM2.5 and NO2 and number of respiratory consultations. Long-term exposure to NO2 was associated with an increase (8%) in preventer inhaler prescriptions only. We found increases in the daily number of GP respiratory consultations and inhaler prescriptions following short-term increases in exposure to NO2, PM10 and PM2.5. These associations are more pronounced in children and persist for at least a week. The association with long term exposure to NO2 and preventer inhaler prescriptions indicates likely increased chronic respiratory morbidity.
登录
查看更多内容
DOI：
10.1183/13993003.00419-2016
发表时间：
2017-01
期刊：
The European respiratory journal
影响因子：
--
作者：
Thurston GD;Kipen H;Annesi-Maesano I;Balmes J;Brook RD;Cromar K;De Matteis S;Forastiere F;Forsberg B;Frampton MW;Grigg J;Heederik D;Kelly FJ;Kuenzli N;Laumbach R;Peters A;Rajagopalan ST;Rich D;Ritz B;Samet JM;Sandstrom T;Sigsgaard T;Sunyer J;Brunekreef B
通讯作者：
Brunekreef B
影响因子：
9.6
作者：
Laurent, Olivier;Pedrono, Gaelle;Bard, Denis
通讯作者：
Bard, Denis
影响因子：
4.4
作者：
Sofianopoulou, Eleni;Rushton, Stephen P.;Pless-Mulloli, Tanja
通讯作者：
Pless-Mulloli, Tanja
影响因子：
10.4
作者：
Shi L;Zanobetti A;Kloog I;Coull BA;Koutrakis P;Melly SJ;Schwartz JD
通讯作者：
Schwartz JD
影响因子：
3.7
作者：
Kloog I;Coull BA;Zanobetti A;Koutrakis P;Schwartz JD
通讯作者：
Schwartz JD