A national scale assessment of the impact of climate change on asthma morbidity

气候变化对哮喘发病率影响的全国范围评估

• 批准号: 8474040
• 负责人: Amir Sapkota
• 金额: $ 22.95万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-15 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8474040
• 关键词: Accident and Emergency department; Address; Air; Air Pollution; American; Area; Asthma; Carbon Dioxide; Characteristics; Child; Climate; Communities; Confidence Intervals; Data; Databases; Decision Making; Demography; Detection; Dimensions; Disease; Epidemiologic Studies; Epidemiology; Event; Flowers; Frequencies; Funding; Future; Goals; Hay fever; Health; Health Care Costs; Health Services Accessibility; Hospitalization; Hot Spot; Hot Springs; Image; Individual; Interdisciplinary Study; Knowledge; Length; Life; Link; Maps; Measures; Methodology; Metric; Morbidity - disease rate; National Health Interview Survey; National Institute of Environmental Health Sciences; Odds Ratio; Outcome; Ozone; Pathway interactions; Pilot Projects; Plants; Policies; Pollen; Population; Prevalence; Production; Public Health; Quality of life; Readiness; Reporting; Research; Research Design; Resolution; Resources; Respondent; Risk; Risk Factors; Sampling; Science; Seasons; Signal Transduction; Surface; System; Temperature; Time; Tobacco; United States National Aeronautics and Space Administration; Visit; Vulnerable Populations; Weather; Work; anthropogenesis; atmospheric carbon dioxide; base; climate change; early onset; experience; land cover; land use; public health relevance; remote sensing; statistics; tool; working group

DESCRIPTION (provided by applicant): Even though anthropogenic climate change has been under way for several decades, no studies to date have directly quantified the impact of climate change on asthma morbidity - we will fill this critical knowledge gap. A recent report by the NIEHS-led Interagency Working Group on Climate Change and Health (IWGCCH) concluded that climate change will likely amplify the existing environmental triggers of asthma, resulting in more severe and frequent disease exacerbation. The working group identified several critical data gaps including the need to a) establish climate-sensitive exposure metrics, with appropriate temporal and spatial dimensions, that are most strongly associated with asthma, b) identify and map populations at increased risk of climate-related morbidity, and c) investigate the relationship between climate variables, altered plant phenology and asthma exacerbations. We will fill these critical gaps through the work of our interdisciplinary team with expertise in satelite remote sensing, climate science, public health, spatial statistics and aerobiology. Specifically, we will 1) link historical plant phenology, meteorological and air pollution data with asthma morbidity data from the National Health Interview Survey for the 1988-2010 period; 2) use the newly linked data to conduct a national scale assessment of the impact of climate change on asthma morbidity; and 3) geographically and temporally identify communities with increased risk of climate change related asthma morbidity using spatio-temporal cluster detection methodologies. The two-decades of data that we will use encompasses various natural climate modes such as El Ni¿o-Southern Oscillation (ENSO), Pacific Decadal Oscillation (PDO) and North Atlantic Oscillation (NAO) allowing us to investigate their impact on asthma morbidity. We will capture climate change signals using metrics likely to be strongly associated with asthma, including frequency of extreme weather events as well as changes in plant phenology that are known to respond to gradual changes in temperature and atmospheric CO2 concentration. This will enable us to - for the first time - directly quantify the impact of climate change on asthma morbidity using observed data, while adjusting for other time-varying confounders (e.g. land use change, population increases, demographic shift, access to healthcare). Using pilot funding, we have successfully linked meteorological data with NHIS respondents for 2006-2008, and begun to investigate the association between extreme weather events and asthma morbidity. Preliminary results suggest that respondents living in areas that experienced unusually hot springs days during the previous 5 years were at increased risk of hay fever (AOR=1.24 (95% CI 1.04, 1.48)) and ER visits for asthma (AOR=1.68 (CI 1.08, 2.62)). Requested funding will enable us to expand the pilot study to additional years (1988-2010) and incorporate plant phenology. The proposed study will directly address the aforementioned critical research needs identified by IWGCCH and provide for the first time, a national scale assessment of the impact of climate change on asthma morbidity based on observed data.

描述(申请人提供)：尽管人为气候变化已经进行了几十年，但到目前为止还没有研究直接量化气候变化对哮喘发病率的影响--我们将填补这一关键的知识空白。NIEHS领导的气候变化与健康跨机构工作组(IWGCCH)最近的一份报告得出结论，气候变化可能会放大哮喘的现有环境触发因素，导致 病情加重更严重、更频繁。工作组确定了几个关键的数据缺口，包括：a)需要建立与哮喘关系最密切的具有适当时间和空间维度的气候敏感暴露指标；b)确定和绘制气候相关发病风险增加的人口；以及c)调查气候变量、植物物候变化和哮喘加重之间的关系。我们将通过我们的跨学科团队在卫星遥感、气候科学、公共卫生、空间统计和航空生物学方面的专业知识来填补这些关键空白。具体地说，我们将1)将历史植物物候、气象和空气污染数据与1988-2010年期间全国健康访谈调查的哮喘发病率数据联系起来；2)使用新关联的数据对气候变化对哮喘发病率的影响进行全国范围的评估；3)使用时空集群检测方法在地理和时间上确定与气候变化相关的哮喘发病率风险增加的社区。我们将使用的二十年数据涵盖了各种自然气候模式，如厄尔尼诺-南方涛动(ENSO)、太平洋年代际涛动(PDO)和北大西洋涛动(NAO)，使我们能够调查它们对哮喘发病率的影响。我们将使用可能与哮喘密切相关的指标来捕捉气候变化信号，包括极端天气事件的频率以及已知对温度和大气二氧化碳浓度逐渐变化做出反应的植物物候变化。这将使我们第一次能够使用观测数据直接量化气候变化对哮喘发病率的影响，同时根据其他时间变化的混杂因素(例如土地利用变化、人口增加、人口变化、获得医疗保健的机会)进行调整。利用试点资金，我们已经成功地将气象数据与国家健康保险制度2006-2008年的受访者联系起来，并开始调查极端天气事件和哮喘发病率之间的联系。初步结果显示，居住在过去5年中经历异常温泉的地区的受访者患花粉热的风险(AOR=1.24(95%可信区间1.04，1.48))和因哮喘而去急诊室就诊的风险(AOR=1.68(CI 1.08，2.62))。申请的资金将使我们能够将试点研究扩大到更多的年份(1988-2010年)，并纳入植物物候学。拟议的研究将直接满足IWGCCH确定的上述关键研究需求，并首次根据观察数据对气候变化对哮喘发病率的影响进行全国范围的评估。