Dust storms and emergency department visits in four southwestern US states

摘要 沙尘暴是由强风引起的大气事件，导致地面上的沙尘悬浮， 严重降低了空气质量和能见度。沙尘暴空气污染的主要特点是浓度高。 土壤中可能含有重金属、杀虫剂和孢子或分生孢子的颗粒物 微生物。在东亚、南欧和澳大利亚的研究表明，短期内 沙尘暴对心肺健康的影响。在美国，沙尘暴活动在过去几年中有所增加 过去20年，特别是在西南地区，由于其干旱的气候。然而，尽管尘埃活动很高， 在许多州，美国在沙尘暴及其对健康影响的研究方面已经落后。这个为期两年的项目 将通过利用(1)追溯地描述沙尘暴的新方法来填补这一重要的知识空白， 以及(2)现有的病人级急诊科(ED)就诊和住院数据库。在这 在这个项目中，我们将使用一些不同的方法和数据来源来描述沙尘暴暴露的特征。 这是由于在沙尘暴研究中公认的暴露评估挑战，因为 环境中粗颗粒物的监测数量稀少，缺乏标准化的分类 沙尘暴。在目标1中，我们将汇编几个沙尘暴暴露指标，包括(1)两个基于显示器的粉尘 来自监管环境空气污染监测网络的事件度量，(2)数据产品组合 大气模式模拟和星载气溶胶光学厚度，(3)地面气溶胶光学 深度反演产品，以及(4)美国国家气象局风暴数据库中的报告。我们会 然后检查不同沙尘暴指标的时空一致性，以及 其沙尘事件的长期频次趋势和季节分布。在目标2中，我们将评估 2005年至2016年期间，美国西南部四个州的沙尘暴事件和每天的ED访问。具体来说， 我们将进行时间序列分析，以评估沙尘暴事件与边缘之间的短期联系。 访问亚利桑那州、加利福尼亚州、内华达州和犹他州，以了解各种结果，包括过敏反应、心肺疾病 疾病、感染和机动车事故引起的疾病。一个特别令人感兴趣的结果是山谷 这是因为研究区域包括山谷热的流行地区。增加孢子传播率 风尘被认为是最近山谷热发病率上升的原因之一。风险稳健性 将对使用不同沙尘暴暴露指标和暴露滞后结构的估计进行评估。结果 这个项目将有助于我们了解美国沙尘暴对健康的影响，提供 改进对风尘和沙尘暴事件的暴露评估的方向，并为 随后的研究，以检查个人和社区一级的因素以及 可能带来脆弱性的沙尘暴特征。

ABSTRACT Dust storms are atmospheric events precipitated by strong winds that cause dust on the ground to be suspended, severely reducing air quality and visibility. Dust storm air pollution is largely characterized by high concentrations of particulate matter from soil that can contain heavy metals, pesticides, and spores or conidia of microorganisms. Studies in East Asia, southern Europe, and Australia have demonstrated short-term adverse cardiorespiratory health effects of dust storms. In the United States, dust storm activity has increased over the past 20 years, particularly in the southwestern region due to its arid climate. However, despite high dust activity in many states, the US has lagged behind in the study of dust storms and their health effects. This 2-year project will fill this important knowledge gap by utilizing (1) new approaches to characterize dust storms retrospectively, and (2) an existing database of patient-level emergency department (ED) visits and hospitalizations. In this project, we will characterize dust storms exposures using a number of different approaches and data sources. This is motivated by the well-recognized exposure assessment challenge in dust storm research due to the sparse number of monitors for ambient coarse particulate matter and the lack of standardized classifications for dust storms. In Aim 1, we will compile several dust storm exposure metrics, including (1) two monitor-based dust event metrics from regulatory ambient air pollution monitoring networks, (2) a data product combining atmospheric model simulation and satellite-derived aerosol optical depth, (3) a ground-based aerosol optical depth inversion product, and (4) reports in the United States National Weather Service Storm Database. We will then examine the spatial-temporal concordance of different dust storm metrics, as well as consistency between their long-term dust event frequency trends and seasonal profiles. In Aim 2, we will assess associations between dust storm events and daily ED visits in four southwest US states during the period 2005 to 2016. Specifically, we will conduct time-series analyses to estimate short-term associations between dust storm events and ED visits Arizona, California, Nevada, and Utah for various outcomes, including allergic reactions, cardiorespiratory diseases, infections, and those caused by motor vehicle accidents. One particular outcome of interest is valley fever because the study region includes endemic areas for valley fever. Increased spore transmission via windblown dust has been suggested to contribute to the recent rise in valley fever incidence. Robustness of risk estimates using different dust storm exposure metrics and exposure lag structures will be evaluated. Results from this project will contribute to our knowledge in the health effects of dust storms in the United States, provide directions to improve exposure assessment for windblown dust and dust storm events, and provide support for subsequent studies to examine effect modification by individual-level and community-level factors, as well as by dust storm characteristics that may confer vulnerability.