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Tiwari I, Syer J, Spitzer D, Hodgins S, Tamrakar SR, Dhimal M, Yamamoto SS. Linking weather and health outcomes: Examining the potential influences of weather factors and particulate matter pollution on adverse pregnancy outcomes in the Kavre district, Nepal. ENVIRONMENTAL RESEARCH 2024; 256:119212. [PMID: 38797462 DOI: 10.1016/j.envres.2024.119212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/30/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Adverse pregnancy outcomes (APOs) include stillbirth, preterm birth, and low birthweight (LBW). Studies exploring the impact of weather factors and air pollution on APOs are scarce in Nepal. We examined the impacts of prenatal exposure to temperature, precipitation, and air pollution (PM2.5) on APOs among women living in Kavre, Nepal. METHODS We conducted a hospital and rural health centers-based historical cohort study that included health facility birth records (n = 1716) from the Nepali fiscal year 2017/18 through 2019/20. We linked health records to temperature, precipitation, and PM2.5 data for Kavre for the six months preceding each birth. A random intercept model was used to analyze birthweight, while a composite APO variable, was analyzed using multivariable logistic regression in relation to environmental exposures. RESULTS The proportion of LBW (<2500 gm), preterm birth (babies born alive before 37 weeks of gestation), and stillbirth was 13%, 4.3%, and 1.5%, respectively, in this study. Overall, around 16% of the study participants had one or more APOs. Total precipitation (β: 0.17, 95% CI 0.01 to 0.33, p = 0.03) had a positive effect on birthweight in the wetter season. Negative effects for mean maximum (β: 33.37, 95% CI -56.68 to -10.06, p = 0.005), mean (β: 32.35, 95% CI -54.44 to -10.27, p = 0.004), and mean minimum temperature (β: 29.28, 95% CI -49.58 to -8.98, p = 0.005) on birthweight was also observed in the wetter season. CONCLUSION A positive effect of temperature (mean maximum, mean, and mean minimum) and total precipitation on birthweight was found in the wetter season. This study emphasizes the need for future research using larger cohorts to elucidate these complex relationships in Nepal.
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Affiliation(s)
- Ishwar Tiwari
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
| | - Joey Syer
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Denise Spitzer
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Stephen Hodgins
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Suman R Tamrakar
- Department of Obstetrics and Gynecology, Dhulikhel Hospital, Kavre, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council, Ram Shah Path, Kathmandu, Nepal
| | - Shelby S Yamamoto
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, T6G 1C9, Canada
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Boura D, Spanakis M, Markakis G, Notas G, Lionis C, Tzanakis N, Paraskakis E. Exploring the Relationship between Wind Patterns and Hospital Admissions Due to Respiratory Symptoms in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:717. [PMID: 38929296 PMCID: PMC11201383 DOI: 10.3390/children11060717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Respiratory disorders significantly impact adolescents' health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory health, particularly in regions characterized by distinct annual wind patterns. Crete is situated in the central-eastern Mediterranean Sea and frequently faces southerly winds carrying Sahara Desert sand from Africa and northerly winds from the Aegean Sea. This retrospective study analyzes long-term wind direction data and their relationship to respiratory symptoms observed in children up to 14 years old admitted at the University Hospital of Heraklion between 2002 and 2010. Symptoms such as headache, dyspnea, dry cough, dizziness, tachypnea, throat ache, and earache were predominantly reported during the presence of southern winds. Fever, productive cough, and chest pain were more frequently reported during northern winds. Cough was the most common symptom regardless of the wind pattern. Southern winds were significantly associated with higher probabilities of productive or non-productive cough, headache, dyspnea, tachypnea, dizziness, earache, and throat ache. Northern winds were related to a higher incidence of productive cough. Rhinitis, asthma, allergies, pharyngitis, and sinusitis were related to southern winds, while bronchiolitis and pneumonia were associated with northern winds. These findings underscore the critical role of local climatic factors, emphasizing their potential impact on exacerbating respiratory conditions in children. Moreover, they point out the need for further research to elucidate the underlying mechanisms and develop targeted interventions for at-risk populations.
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Affiliation(s)
- Despoina Boura
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Marios Spanakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece;
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research & Technology–Hellas, 71110 Heraklion, Greece
| | - George Markakis
- Department of Social Work, Faculty of Health Sciences, Hellenic Mediterranean University, 71004 Heraklion, Greece;
| | - George Notas
- Department of Emergency Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Nikolaos Tzanakis
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
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Oerther S, Bultas M. Heat Metrics and Maternal-Child Health Diagnoses in Emergency Departments in the United States: A Scoping Review. MCN Am J Matern Child Nurs 2024:00005721-990000000-00056. [PMID: 38874459 DOI: 10.1097/nmc.0000000000001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVE To summarize current research on associations between heat metrics and emergency department discharge diagnoses for US pregnant women and children from birth to age 18 via a scoping review. BACKGROUND Climate change directly contributes to extreme weather conditions and environmental changes and indirectly affects health and the health care system. Pregnant women and children are believed to be more susceptible to extreme heat, but few empirical studies have been conducted evaluating effects of heat metrics on these populations. METHODS Ovid MEDLINE, CIHAHL, SCOPUS, Web of Science, JSTOR, and PsycINFO databases were searched using a combination of key words. RESULTS Twelve studies were selected for this review. In pregnant women, positive associations were found between mean daily temperature and multiple subtypes of pregnancy complications, including threatened or spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension. In children, positive associations were found with all-cause diagnoses; asthma; dehydration; electrolyte disorders; heat-related illness; infection; endocrine, nutritional, and metabolic diseases; injury; and otitis media and external emergency department discharge diagnoses and temperature or heatwave versus non-heatwave. CONCLUSION By tracking associations between maternal-child emergency department discharge diagnoses and various heat metrics, researchers can contribute to better clinical practices that promote environmental justice and climate resilience.
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Deng L, Chen X, Ma P, Wu Y, Okoye CO, Du D, Deng Q. The combined effect of oxidative stress and TRPV1 on temperature-induced asthma: Evidence in a mouse model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123313. [PMID: 38185356 DOI: 10.1016/j.envpol.2024.123313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
Temperature is one of the possible activators for asthma. As global warming continues, the health hazard of high temperatures is increasing. It is unclear, nevertheless, how high temperatures affect asthma. The research aims to examine how asthma is affected by high temperatures and underlying molecular mechanisms. The BALB/c mice were adopted in a model of asthma. The mice were exposed at 24 °C, 38 °C and 40 °C for 4h on weekdays from day 1 to day 30. After the experiment, the lung function was measured in vivo, and then serum protein, pulmonary inflammation and immunohistochemistry assay was assessed in vitro. As the temperature increased from 24 °C to 40 °C, there was a significant increase in serum protein, while there is no discernible difference in serum protein of OVA-sIgE and OVA-sIgG between the OVA (38 °C) group and OVA (24 °C) group. The immunohistochemistry assay showed a change in the pro-inflammatory cytokines. The histopathological analysis exhibited the change of airway structure after high-temperature exposure, especially for exposure at 40 °C. The results of signals protein showed a remarkable rise of TRPV1 for OVA+40 °C. Our results revealed that high temperatures may make asthmatic airway dysfunction severe, and the higher the temperature, the more serious asthma. The oxidative stress and TRPV1 receptor can be a potential drug target for asthma. It will provide a new tool for precision medicine in asthma.
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Affiliation(s)
- Linjing Deng
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China.
| | - Xunfeng Chen
- Biofuels Institute of Jiangsu university, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Ping Ma
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Yang Wu
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Charles Obinwanne Okoye
- School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China; Department of Zoology & Environmental Biology, University of Nigeria, Nsukka, 410001, Nigeria
| | - Daolin Du
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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He L, Evans S, Norris C, Barkjohn K, Cui X, Li Z, Zhou X, Li F, Zhang Y, Black M, Bergin MH, Zhang J(J. Associations between personal apparent temperature exposures and asthma symptoms in children with asthma. PLoS One 2023; 18:e0293603. [PMID: 37956155 PMCID: PMC10642815 DOI: 10.1371/journal.pone.0293603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Ambient temperature and relative humidity can affect asthma symptoms. Apparent temperature is a measure of temperature perceived by humans that takes into account the effect of humidity. However, the potential link between personal exposures to apparent temperature and asthma symptoms has not been investigated. We conducted a panel study of 37 asthmatic children, aged 5-11 years, during an early spring season (average daily ambient temperature: 14°C, range: 7-18°C). Asthma symptoms were measured 4 times for each participant with a 2-week interval between consecutive measurements using the Childhood Asthma-Control Test (C-ACT). Average, minimum, and maximum personal apparent temperature exposures, apparent temperature exposure variability (TV), and average ambient temperature were calculated for the 12 hours, 24 hours, week, and 2 weeks prior to each visit. We found that a 10°C lower in 1-week and 2-week average & minimum personal apparent temperature exposures, TV, and average ambient temperature exposures were significantly associated with lower total C-ACT scores by up to 2.2, 1.4, 3.3, and 1.4 points, respectively, indicating worsened asthma symptoms. Our results support that personal apparent temperature exposure is potentially a stronger driver than ambient temperature exposures for the variability in asthma symptom scores. Maintaining a proper personal apparent temperature exposure could be an effective strategy for personalized asthma management.
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Affiliation(s)
- Linchen He
- Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, Pennsylvania, United States of America
| | - Shoshana Evans
- Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, Pennsylvania, United States of America
| | - Christina Norris
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Karoline Barkjohn
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina, United States of America
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, United States of America
| | - Xiaoxing Cui
- Nicholas School of the Environment, Duke University, Durham, North Carolina, United States of America
| | - Zhen Li
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaojian Zhou
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Li
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Marilyn Black
- Underwriters Laboratories, Inc, Marietta, Georgia, United States of America
| | - Michael H. Bergin
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina, United States of America
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Duke Kunshan University, Kunshan, Jiangsu Province, China
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6
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Idrose NS, Lodge CJ, Peters RL, Douglass JA, Koplin JJ, Lowe AJ, Perrett KP, Tang MLK, Newbigin EJ, Abramson MJ, Erbas B, Vicendese D, Dharmage SC. The role of short-term grass pollen exposure in food skin-prick test reactivity, food allergy, and eczema flares in children. Pediatr Allergy Immunol 2022; 33:e13862. [PMID: 36282135 PMCID: PMC9828461 DOI: 10.1111/pai.13862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/13/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND While the relationship between pollen and respiratory allergies is well-documented, the role of short-term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population-based sample of children. METHODS We investigated 1- (n = 1108) and 6-year-old (n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1-lag 3) and cumulatively (lag 0-3). Associations between grass pollen and food skin-prick test reactivity (SPT ≥ 2 mm at age 1 year and ≥ 3 mm at age 6 years), eczema flares, challenge-confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food-specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers. RESULTS Grass pollen at lag 0-3 (every 20 grains/m3 increase) was associated with an up to 1.2-fold increased odds of food SPT reactivity and eczema flares in 6-year-olds. In 1-year-olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut-allergic 1-year-olds only. CONCLUSION Increasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut-allergic infants may be related to immune activation and/or peanut and grass pollen cross-reactivity leading to a lower reaction threshold.
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Affiliation(s)
- Nur Sabrina Idrose
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia
| | - Jo A Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kirsten P Perrett
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ed J Newbigin
- School of Biosciences, The University of Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Don Vicendese
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Wu Z, Miao C, Li H, Wu S, Gao H, Liu W, Li W, Xu L, Liu G, Zhu Y. The lag-effects of meteorological factors and air pollutants on child respiratory diseases in Fuzhou, China. J Glob Health 2022; 12:11010. [PMID: 35973040 PMCID: PMC9380967 DOI: 10.7189/jogh.12.11010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The effects of meteorological factors and air pollutants on respiratory diseases (RDs) were various in different populations according to the demographic characteristics, and children were considered a vulnerable population. Previous studies were mainly based in cities with serious air pollution. This study aimed to qualify the lag effects of meteorological factors and air pollution on respiratory diseases among children under 18 years old in Fuzhou. Methods Meteorological data, air pollutants concentrations and hospital admission data of Fujian Maternity and Child Health Hospital between 2015 and 2019 were collected. A Distributed Lag Nonlinear Model (DLNM) was used to evaluate the nonlinear and lagged effect of meteorological factors and air pollutants on daily RDs number. A subgroup analysis was also conducted to evaluate the effect on different sex groups and age groups. Results A total number of 796 125 RDs visits was included during the study period. For meteorological factors, lower mean temperature and relative humidity were significantly associated with daily RDs number (peak relative risk (RR) = 1.032 (95% confidence interval (CI) = 1.011-1.053) and 1.021 (95% CI = 1.013-1.029)), while lower wind speed showed a significant association at low range (peak RR = 0.995 (95% CI = 0.992-0.999)). Temperature warming was a significant protective factor for RDs (peak RR = 0.989 (95% CI = 0.986-0.993)). For air pollutants, SO2, NO2, PM10 and PM2.5 were all significantly associated with RDs (peak RR = 1.028 (95% CI = 1.022-1.035), 1.024 (95% CI = 1.013-1.034), 1.036 (95% CI = 1.025-1.047), 1.028 (95% CI = 1.019-1.037)), and the relationship had no threshold. The estimated RR and peak lag day did not change extremely between subgroups. Conclusions The findings provide statistical evidence for the prevention of child RDs. In addition, our findings suggested that even at low concentrations, air pollutants still have negative effects on the respiratory system.
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Affiliation(s)
- Zhengqin Wu
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Chong Miao
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Haibo Li
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Shaowei Wu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Haiyan Gao
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Wenjuan Liu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China
| | - Wei Li
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Libo Xu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Guanghua Liu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China
| | - Yibing Zhu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Disease Research, Fuzhou, China
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Fu J, Liu Y, Zhao Y, Chen Y, Chang Z, Xu KF, Fan Z. Increased Risk of Hospital Admission for Asthma from Short-Term Exposure to Low Air Pressure. J Asthma Allergy 2022; 15:1035-1043. [PMID: 35967095 PMCID: PMC9365019 DOI: 10.2147/jaa.s367308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/10/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jia Fu
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yanbo Liu
- Department of International Medical Services; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yakun Zhao
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yuxiong Chen
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Zhenge Chang
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Kai-Feng Xu
- Department of Respiratory Medicine; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Zhongjie Fan
- Department of Cardiology; Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, People’s Republic of China
- Correspondence: Zhongjie Fan, Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, No. 1, Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel/Fax +86 010 6915 6114, Email
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Wang J, Yu L, Deng J, Gao X, Chen Y, Shao M, Zhang T, Ni M, Pan F. Short-term effect of meteorological factors on the risk of rheumatoid arthritis hospital admissions: A distributed lag non-linear analysis in Hefei, China. ENVIRONMENTAL RESEARCH 2022; 207:112168. [PMID: 34655606 DOI: 10.1016/j.envres.2021.112168] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/05/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease, mainly characterized by erosional arthritis. The proportion of adults suffering from RA is about 0.5%-1%. There have been reports on the association of rainfall and traffic-related air pollutants with RA hospitalization rates. However, there have been no studies on the association of diurnal temperature range (DTR) and relative humidity (RH) with RA hospitalization rates. This study aimed to examine the short-term association of DTR, RH and other meteorological factors with the hospital admission rate of RA patients, while excluding the interference of PM2.5, SO2, NO2, CO and O3 atmospheric pollutants. We collected daily RA occupancy rate and meteorological factor data in Hefei city from 2015 to 2018 and used the generalized additive model (GAM) combined with the distributed lag nonlinear model (DLNM) for time series analysis, and further stratified analysis by gender and age. Single-day and cumulative-day risk estimates of RA admissions were expressed as relative risk (RR) and its 95% confidence interval (95% CI). For the cumulative-day lag model, high RH was statistically significant after cumulative lag 0-8 days, and the effect gradually increases. Stratified analysis shows that females seem to be more susceptible to high or extremely high DTR and RH exposure, and extremely high DTR exposure may increase the risk of RA admission in all populations. In conclusion, this study found that high DTR and high RH exposure increased the risk of hospitalization in RA patients and provided clues to the potential association between other meteorological factors and RA.
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Affiliation(s)
- Jinian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China; Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Lingxiang Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Xing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Ming Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Man Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
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Alharbi ET, Nadeem F, Cherif A. Predictive models for personalized asthma attacks based on patient's biosignals and environmental factors: a systematic review. BMC Med Inform Decis Mak 2021; 21:345. [PMID: 34886852 PMCID: PMC8656014 DOI: 10.1186/s12911-021-01704-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asthma is a chronic disease that exacerbates due to various risk factors, including the patient's biosignals and environmental conditions. It is affecting on average 7% of the world population. Preventing an asthma attack is the main challenge for asthma patients, which requires keeping track of any risk factor that can cause a seizure. Many researchers developed asthma attacks prediction models that used various asthma biosignals and environmental factors. These predictive models can help asthmatic patients predict asthma attacks in advance, and thus preventive measures can be taken. This paper introduces a review of these models to evaluate the used methods, model's performance, and determine the need to improve research in this field. METHOD A systematic review was conducted for the research articles introducing asthma attack prediction models for children and adults. We searched the PubMed, ScienceDirect, Springer, and IEEE databases from January 2000 to December 2020. The search includes the prediction models that used biosignal, environmental, and both risk factors. The research article's quality was assessed and scored based on two checklists, the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and the Critical Appraisal Skills Programme clinical prediction rule checklist (CASP). The highest scored articles were selected to review. RESULT From 1068 research articles we reviewed, we found that most of the studies used asthma biosignal factors only for prediction, few of the studies used environmental factors, and limited studies used both of these factors. Fifteen different asthma attack predictive models were selected for this review. we found that most of the studies used traditional prediction methods, like Support Vector Machine and regression. We have identified the pros and cons of the reviewed asthma attack prediction models and propose solutions to advance the studies in this field. CONCLUSION Asthma attack predictive models become more significant when using both patient's biosignal and environmental factors. There is a lack of utilizing advanced machine learning methods, like deep learning techniques. Besides, there is a need to build smart healthcare systems that provide patients with decision-making systems to identify risk and visualize high-risk regions.
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Affiliation(s)
- Eman T. Alharbi
- Department of Information Systems, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Farrukh Nadeem
- Department of Information Systems, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Asma Cherif
- Department of Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Grjibovski AM, Adilbekova B, Omralina E, Imangazinova S, Akhmetova Z, Ainabai A, Kalmakhanov S, Aituganova A, Kosbayeva A, Menne B, Odland JØ. Effects of air temperature on the number of ambulance calls for asthma during cold season in Nur-Sultan- the second coldest capital in the world. Int J Circumpolar Health 2021; 80:1978228. [PMID: 34547983 PMCID: PMC8462835 DOI: 10.1080/22423982.2021.1978228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Deleterious effect of cold on overall mortality is well-established. We studied associations between the air temperature and the number f ambulance calls for asthma in Nur-Sultan, Kazakhstan – the second coldest capital in the world. Daily counts of ambulance calls for asthma in Nur-Sultan for the cold seasons (October-March) 2006–2010 were obtained from the Municipal Ambulance Station. Associations between the number of calls and mean and minimum apparent temperatures (average for lags 0–15) were studied using first-order Poisson auto-regression models controlling for wind speed and effects of month, year, weekends and holidays. Altogether, there were 7373 ambulance calls for asthma during the study period. An inverse association between minimum apparent temperature and the number of calls was observed for the age-group 60 years and older. A decrease of the minimum apparent temperature by 1°C was associated with an increase in the number of calls by 1.7% (95% CI: 0.1%-3.3%) across the whole temperature spectrum. No associations in other age groups were found. Our results suggest an inverse association between the average 15-day lag minimum apparent temperature and the number of ambulance calls during the cold season in Nur-Sultan, but this is limited to the oldest age-group.
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Affiliation(s)
- Andrej M Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia.,Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.,Department of Public Health and Health Policy, Al Farabi Kazakh National University, Almaty, Kazakhstan
| | - Bibigul Adilbekova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Elvira Omralina
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Saule Imangazinova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Zhanar Akhmetova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Ayagul Ainabai
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Sundetgali Kalmakhanov
- Department of Public Health and Health Policy, Al Farabi Kazakh National University, Almaty, Kazakhstan
| | - Aliya Aituganova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Aliya Kosbayeva
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Bettina Menne
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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12
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Lei X, Liu L, Chen R, Liu C, Hong J, Cao L, Lu Y, Dong X, Chen X, Qiu X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Kan H, Zhou Y, Zhang X. Temperature changes between neighboring days and childhood asthma: a seasonal analysis in Shanghai, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:827-836. [PMID: 33230642 DOI: 10.1007/s00484-020-02057-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 06/11/2023]
Abstract
Few evidences are available about the impact of temperature variation on childhood asthma in different seasons. This study aimed to assess the influence of temperature changes between neighboring days (TCN) on the exacerbation of asthma among children. Daily outpatient visits for childhood asthma (DOVCA) were collected from 17 main hospitals in Shanghai, China, from 2016 to 2018. A quasi-Poisson regression combined with distributed lagged nonlinear models was employed to estimate the association between TCN and asthma visits in cool or warm seasons, after controlling for short- and long-term trends, day of week, holidays, daily mean temperature, daily mean relative humidity, and air pollutants. The TCN varied from - 9.6 to 6.7 °C. The relationship between TCN and DOVCA greatly varied by season. In warm seasons, positive TCN (temperature rise) was associated with higher risks of asthma outpatient visits and negative TCN (temperature drop) was associated with lower risks; the associations were present on lag 1 day and lasted for 2 weeks; the cumulative relative risk of childhood asthma over 0 to 14 days was 1.98 (95% confidence interval: 1.42, 2.76) and 0.31 (95% confidence intervals: 0.21, 0.44) comparing a TCN of 2.5 °C (5th percentile) and - 3.2 °C (95th percentile) with 0 °C, respectively. In cool seasons, neither negative nor positive TCN showed significant risks. In conclusion, temperature rise might increase the risk of childhood asthma exacerbation and temperature drop might decrease the risks in warm seasons. There were no statistically significant influences in cool seasons.
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Affiliation(s)
- Xiaoning Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Xinchang Chen
- Guangdong Midea Refrigeration Equipment Co., Ltd, Foshan, Guangdong, China
| | - Xiangwei Qiu
- Guangdong Midea Refrigeration Equipment Co., Ltd, Foshan, Guangdong, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China.
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Linssen RS, den Hollander B, Bont L, van Woensel JBM, Bem RA. The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis. Pathogens 2021; 10:pathogens10050567. [PMID: 34067031 PMCID: PMC8150834 DOI: 10.3390/pathogens10050567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.
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Affiliation(s)
- Rosalie S. Linssen
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
- Amsterdam Reproduction & Development (AR&D) and the Amsterdam Infection & Immunity (AR&I) Research Institutes Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-20-56-62453-E
| | - Bibiche den Hollander
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Louis Bont
- UMCU Laboratory of Translational Immunology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3584 EA Utrecht, The Netherlands;
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, 3703 CD Zeist, The Netherlands
| | - Job B. M. van Woensel
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Reinout A. Bem
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
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Lauffer F, Baghin V, Standl M, Stark SP, Jargosch M, Wehrle J, Thomas J, Schmidt‐Weber CB, Biedermann T, Eyerich S, Eyerich K, Garzorz‐Stark N. Predicting persistence of atopic dermatitis in children using clinical attributes and serum proteins. Allergy 2021; 76:1158-1172. [PMID: 32794228 DOI: 10.1111/all.14557] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is the most common inflammatory skin disease in children, with 30% of all those diagnosed developing chronic or relapsing disease by adolescence. Such disease persistence cannot yet be predicted. The aim of the present study was to predict the natural course of AD using clinical parameters and serum proteins. METHODS Sera of 144 children with AD (age 0-3 years) were analyzed for IgE and 33 cytokines, chemokines, and growth factors. Patient disease course until the age of 7 years was assessed retrospectively. Unsupervised k-means clustering was performed to define disease endotypes. Identified factors associated with AD persistence at the age of 7 years were validated in children with AD in an independent cohort (LISA Munich; n = 168). Logistic regression and XGBoosting methods followed by cross-validation were applied to predict individual disease outcomes. RESULTS Three distinct endotypes were found in infancy, characterized by a unique inflammatory signature. Factors associated with disease persistence were disease score (SCORAD), involvement of the limbs, flexural lesion distribution at the age of 3 years, allergic comorbidities, and disease exacerbation by the trigger factors stress, pollen exposure, and change in weather. Persistence was predicted with a sensitivity of 81.8% and a specificity of 82.4%. Factors with a high impact on the prediction of persistence were SCORAD at the age of 3 years, trigger factors, and low VEGF serum levels. CONCLUSION Atopic dermatitis in infancy comprises three immunological endotypes. Disease persistence can be predicted using serum cytokines and clinical variables.
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Affiliation(s)
- Felix Lauffer
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - Veronika Baghin
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - Marie Standl
- Institute of Epidemiology Helmholtz Center Munich ‐ German Research Center for Environmental Health Neuherberg Germany
| | - Sebastian P. Stark
- ZAUM ‐ Center of Allergy and Environment Technical University of Munich and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL) Munich Germany
| | - Manja Jargosch
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - Julius Wehrle
- Department of Medicine I Medical Center University of Freiburg Freiburg Germany
- German Cancer Consortium (DKTK) Freiburg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Jenny Thomas
- ZAUM ‐ Center of Allergy and Environment Technical University of Munich and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL) Munich Germany
| | - Carsten B. Schmidt‐Weber
- ZAUM ‐ Center of Allergy and Environment Technical University of Munich and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL) Munich Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - Stefanie Eyerich
- ZAUM ‐ Center of Allergy and Environment Technical University of Munich and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL) Munich Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Division of Dermatology and Venereology Department of Medicine Solna, and Center for molecular medicine Karolinska Institutet Stockholm Sweden
| | - Natalie Garzorz‐Stark
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Division of Dermatology and Venereology Department of Medicine Solna, and Center for molecular medicine Karolinska Institutet Stockholm Sweden
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15
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Shankar HM, Rice MB. Update on Climate Change: Its Impact on Respiratory Health at Work, Home, and at Play. Clin Chest Med 2021; 41:753-761. [PMID: 33153692 DOI: 10.1016/j.ccm.2020.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Climate change is a crisis of vast proportions that has serious implications for pulmonary health. Increasing global temperatures influence respiratory health through extreme weather events, wildfires, prolonged allergy seasons, and worsening air pollution. Children, elderly patients, and patients with underlying lung disease are at elevated risk of complications from these effects of climate change. This paper summarizes the myriad ways in which climate change affects the respiratory health of patients at home and in outdoor environments and outlines measures for patients to protect themselves.
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Affiliation(s)
- Hari M Shankar
- Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, 3400 Spruce Street, 839 West Gates Building, Philadelphia, PA 19104, USA.
| | - Mary B Rice
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, KS/BM23, 330 Brookline Avenue, Boston, MA 02215, USA
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16
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Kabir AF, Ng CFS, Yasumoto S, Hayashi T, Watanabe C. Effect of Ambient Temperature on Daily Nebulized Asthma Hospital Visits in a Tropical City of Dhaka, Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030890. [PMID: 33498592 PMCID: PMC7908622 DOI: 10.3390/ijerph18030890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Abstract
The acute effect of temperature on asthma morbidity in Bangladesh is not well understood. As climate varies extensively in different parts of the world, the relation between temperature and asthma might also differ. We investigated the association between temperature and asthma-related hospital visits in the tropical city of Dhaka. We analyzed information from a total of 5989 asthma patients who received ambulatory care in the form of nebulized medication at the National Asthma Center in Mohakhali, Dhaka from February to November 2013. A time-stratified case-crossover study was conducted to estimate the effect of daily temperature, with consideration of delayed effects and possible confounders such as relative humidity and political strikes. An inverse association was observed between temperature and the number of hospital visits. The effect was delayed for approximately a week. A degree centigrade decrease in mean temperature (averaged across lags 0-6) was associated with an increase of approximately 4.5% (95% CI 1.5, 7.5) in all asthma visits. The association was evident in adult males but marginal in elderly males. A positive association (lag 0) was observed among adult females, whereas no association was observed among children. Strikes significantly modified the effect among the elderly. Findings suggest temperature declines affect asthma outcomes in a warm climate, and this effect can be delayed and vary by sex and age group.
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Affiliation(s)
- Ayesha Ferdosi Kabir
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
- Correspondence:
| | - Shinya Yasumoto
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Taiichi Hayashi
- Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan;
| | - Chiho Watanabe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
- National Institute for Environmental Studies, Tsukuba, Ibaraki 305-0053, Japan
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Zhang C, Kong Y, Shen K. The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China. Front Pediatr 2021; 9:689024. [PMID: 34540763 PMCID: PMC8448385 DOI: 10.3389/fped.2021.689024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Asthma can be exacerbated by many triggers, and the heterogeneity of asthma triggers is clear among children with asthma. This study describes asthma triggers using a large-scale electronic dataset from the smartphone-based Chinese Children's Asthma Action Plan (CCAAP) app and aims to examine the difference in asthma triggers among different subgroups of children with asthma. Methods: Data from the smartphone-based CCAAP app between February 22, 2017, and November 23, 2020, were reviewed, and children with asthma who reported their asthma triggers were enrolled. Eight common asthma triggers were listed in the software: upper respiratory infection (URI), allergen sensitization, exercise, emotional disturbances, pungent odors, air pollution/smog, weather change, and tobacco smoke. We compared the incidence of asthma triggers among different subgroups (<6 years vs. 6-17 years; boy vs. girl; eastern region vs. central region vs. western region). Results: We enrolled 6,835 patients with self-reported asthma triggers. When compared by sex, boys had a higher proportion of exercise-triggered asthma than girls (boys vs. girls, 22.5 vs. 19.7%, p < 0.05). The proportion of patients <6 years of age with URI-triggered asthma was higher than that of patients 6-17 years of age (<6 vs. 6-17 years, 80.9 vs. 74.9%, p < 0.001). Patients 6-17 years of age were more likely than patients <6 years of age to report five of the asthma triggers: allergen sensitization (<6 vs. 6-17 years, 26.6 vs. 35.8%, p < 0.001), exercise (<6 vs. 6-17 years, 19.3 vs. 23.7%, p < 0.001), pungent odors (<6 vs. 6-17 years, 8.8 vs. 12.7%, p < 0.001), air pollution/smog (<6 vs. 6-17 years, 9.4 vs. 16.2%, p < 0.001), and tobacco smoke (<6 vs. 6-17 years, 3.5 vs. 5.3%, p < 0.001). In subgroups based on geographical distribution, asthma triggering of allergen sensitization was reported to be the most common in patients from the eastern region (eastern region vs. central region vs. western region, 35.0 vs. 24.6 vs. 28.0%, p < 0.001). Exercise-triggered asthma was found to be the most prevalent among patients from the central region (eastern region vs. central region vs. western region, 21.6 vs. 24.8 vs. 20.4%, p < 0.05). However, the proportion of patients with air pollution/smog as an asthma trigger was the lowest among those from the western region (eastern region vs. central region vs. western region, 14.1 vs. 14.1 vs. 10.8%, p < 0.05). Conclusion: Children with asthma present different types of asthma triggers, both allergenic and nonallergenic. Age, sex, and geographical distribution affect specific asthma triggers. Preventive measures can be implemented based on a patient's specific asthma trigger.
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Affiliation(s)
- Changhao Zhang
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Yan Kong
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Kunling Shen
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, China
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18
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Anenberg SC, Haines S, Wang E, Nassikas N, Kinney PL. Synergistic health effects of air pollution, temperature, and pollen exposure: a systematic review of epidemiological evidence. Environ Health 2020; 19:130. [PMID: 33287833 PMCID: PMC7720572 DOI: 10.1186/s12940-020-00681-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/30/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND Exposure to heat, air pollution, and pollen are associated with health outcomes, including cardiovascular and respiratory disease. Studies assessing the health impacts of climate change have considered increased exposure to these risk factors separately, though they may be increasing simultaneously for some populations and may act synergistically on health. Our objective is to systematically review epidemiological evidence for interactive effects of multiple exposures to heat, air pollution, and pollen on human health. METHODS We systematically searched electronic literature databases (last search, April 29, 2019) for studies reporting quantitative measurements of associations between at least two of the exposures and mortality from any cause and cardiovascular and respiratory morbidity and mortality specifically. Following the Navigation Guide systematic review methodology, we evaluated the risk of bias of individual studies and the overall quality and strength of evidence. RESULTS We found 56 studies that met the inclusion criteria. Of these, six measured air pollution, heat, and pollen; 39 measured air pollution and heat; 10 measured air pollution and pollen; and one measured heat and pollen. Nearly all studies were at risk of bias from exposure assessment error. However, consistent exposure-response across studies led us to conclude that there is overall moderate quality and sufficient evidence for synergistic effects of heat and air pollution. We concluded that there is overall low quality and limited evidence for synergistic effects from simultaneous exposure to (1) air pollution, pollen, and heat; and (2) air pollution and pollen. With only one study, we were unable to assess the evidence for synergistic effects of heat and pollen. CONCLUSIONS If synergistic effects between heat and air pollution are confirmed with additional research, the health impacts from climate change-driven increases in air pollution and heat exposure may be larger than previously estimated in studies that consider these risk factors individually.
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Affiliation(s)
- Susan C. Anenberg
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW, Washington, DC 20052 USA
| | - Shannon Haines
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW, Washington, DC 20052 USA
- Now at: American Lung Association, Springfield, IL USA
| | - Elizabeth Wang
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW, Washington, DC 20052 USA
| | - Nicholas Nassikas
- Department of Pulmonary, Critical Care, and Sleep Medicine, Brown University Alpert Medical School, Providence, RI 02903 USA
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19
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Hu Y, Cheng J, Jiang F, Liu S, Li S, Tan J, Yin Y, Tong S. Season-stratified effects of meteorological factors on childhood asthma in Shanghai, China. ENVIRONMENTAL RESEARCH 2020; 191:110115. [PMID: 32846175 DOI: 10.1016/j.envres.2020.110115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/19/2020] [Accepted: 08/14/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES There has been increasing interest in identifying the adverse effects of ambient environmental factors on asthma exacerbations (AE), but season-stratified effects of meteorological factors on childhood asthma remain unclear. We explored the season-stratified effects of meteorological factors on childhood AE in Shanghai, China. METHODS Poisson generalized linear regression model combined with a distributed lag nonlinear model was used to examine the lagged and nonlinear effects of meteorological factors on childhood AE after adjustment for putative confounders. We also performed a season-stratified analysis to determine whether the season modified the relationship between meteorological factors and childhood AE. RESULTS There were 23,103 emergency department visits (EDVs) for childhood AE, including 15,466 boys and 7637 girls during 2008-2017. Most meteorological factors (e.g., temperature, diurnal temperature range (DTR), relative humidity (RH) and wind speed (WS)) were significantly associated with EDVs for childhood AE, even after adjustment for the confounding effects of air pollutants. In the whole year, extreme cold, moderate heat, higher DTR, lower RH and WS increased the relative risk (RR) for childhood AE. In the cold season, lower RH and wind speed increased the risks of childhood AE (RRlag0-28 for the 5th percentile (p5) of RH: 9.744, 95% CI: 3.567, 26.616; RRlag0-28 for the p5 of wind speed: 10.671, 95% CI: 1.096, 103.879). In the warm season, higher temperature and DTR, lower RH and WS increased the RR for childhood AE (RRlag0-5 for the p95 of temperature: 1.871, 95% CI: 1.246, 2.810; RRlag0-2 for the p95 of DTR: 1.146, 95% CI: 1.010, 1.300; RRlag0-5 for the p5 of RH: 1.931, 95% CI: 1.191, 3.128; RRlag0-2 for the p5 of WS: 1.311, 95% CI: 1.005, 1.709). CONCLUSIONS Extreme meteorological factors appeared to be triggers of EDVs for childhood AE in Shanghai and the effects modified by season. These findings provide evidence for developing season-specific and tailored strategies to prevent and control childhood AE.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shenghui Li
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
| | - Jianguo Tan
- Shanghai Key Laboratory of Meteorology and Health (Shanghai Meteorological Service), Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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McDaniel JT, McDermott RJ, Martinasek MP, White RM. Prevalence of childhood asthma in US military and non-military families: Comparisons by rural-urban residence and geographic region. Chronic Illn 2020; 16:296-306. [PMID: 30335511 DOI: 10.1177/1742395318807546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We sought to determine variables associated with asthma among children from military and non-military families. METHODS We performed secondary data analysis on the 2016 Behavioral Risk Factor Surveillance System. Parents with and without military experience (n = 61,079) were asked whether a child ever had asthma and currently has asthma. We used two multiple logistic regression models to determine the influence of rurality and geographic region on "ever" and "current" asthma in children of military and non-military families, while controlling for socio-demographic and behavioral variables. RESULTS Overall childhood asthma prevalence for children in military families was lower than non-military families (ever, 9.7% vs. 12.9%; currently, 6.2% vs. 8.2%) in 2016. However, multiple logistic regression showed variation in "ever" and "current" asthma among children of military and non-military families by rurality and race. DISCUSSION Developers of public health asthma interventions should consider targeting African-American children of military families living in urban areas. This population is approximately twice as likely to have asthma as Caucasian children of non-military families.
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Affiliation(s)
- Justin T McDaniel
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, IL, USA
| | - Robert J McDermott
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, IL, USA
| | - Mary P Martinasek
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, FL, USA
| | - Robin M White
- Department of Nursing, University of Tampa, Tampa, FL, USA
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Ma R, Liang L, Kong Y, Chen M, Zhai S, Song H, Hou Y, Zhang G. Spatiotemporal variations of asthma admission rates and their relationship with environmental factors in Guangxi, China. BMJ Open 2020; 10:e038117. [PMID: 33033020 PMCID: PMC7542934 DOI: 10.1136/bmjopen-2020-038117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The study aimed to determine if and how environmental factors correlated with asthma admission rates in geographically different parts of Guangxi province in China. SETTING Guangxi, China. PARTICIPANTS This study was done among 7804 asthma patients. PRIMARY AND SECONDARY OUTCOME MEASURES Spearman correlation coefficient was used to estimate correlation between environmental factors and asthma hospitalisation rates in multiple regions. Generalised additive model (GAM) with Poisson regression was used to estimate effects of environmental factors on asthma hospitalisation rates in 14 regions of Guangxi. RESULTS The strongest effect of carbon monoxide (CO) was found on lag1 in Hechi, and every 10 µg/m3 increase of CO caused an increase of 25.6% in asthma hospitalisation rate (RR 1.26, 95% CI 1.02 to 1.55). According to the correlation analysis, asthma hospitalisations were related to the daily temperature, daily range of temperature, CO, nitrogen dioxide (NO2) and particulate matter (PM2.5) in multiple regions. According to the result of GAM, the adjusted R2 was high in Beihai and Nanning, with values of 0.29 and 0.21, which means that environmental factors are powerful in explaining changes of asthma hospitalisation rates in Beihai and Nanning. CONCLUSION Asthma hospitalisation rate was significantly and more strongly associated with CO than with NO2, SO2 or PM2.5 in Guangxi. The risk factors of asthma exacerbations were not consistent in different regions, indicating that targeted measures should differ between regions.
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Affiliation(s)
- Rui Ma
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Kaifeng, China
| | - Lizhong Liang
- The Affiliated Hospital, Guangdong Medical University, Zhanjiang, China
| | - Yunfeng Kong
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Kaifeng, China
| | - Mingyang Chen
- The Affiliated Hospital, Guangdong Medical University, Zhanjiang, China
| | - Shiyan Zhai
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Kaifeng, China
| | - Hongquan Song
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Kaifeng, China
| | - Yane Hou
- College of Computer and Information Engineering, Henan University, Kaifeng, China
| | - Guangli Zhang
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Kaifeng, China
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Yu HR, Lin CHR, Tsai JH, Hsieh YT, Tsai TA, Tsai CK, Lee YC, Liu TY, Tsai CM, Chen CC, Chang CH, Hsu TY, Niu CK. A Multifactorial Evaluation of the Effects of Air Pollution and Meteorological Factors on Asthma Exacerbation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114010. [PMID: 32512940 PMCID: PMC7313451 DOI: 10.3390/ijerph17114010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 01/05/2023]
Abstract
In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO2; NO2; O3; CO; PM2.5; PM10) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered.
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Affiliation(s)
- Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kaohsiung 83301, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Correspondence: ; Tel.: +886-7-5252000 (ext. 4339); Fax: +886-7-5254-301
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan;
- PhD Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung 80737, Taiwan
| | - Yun-Ting Hsieh
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Ti-An Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chang-Ku Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Yi-Chen Lee
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Ta-Yu Liu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Min Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Cheng Chen
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Hao Chang
- Department of Respiratory Therapy, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Te-Yao Hsu
- Department of Obstetrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Chen-Kuang Niu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
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Ma R, Liang L, Kong Y, Zhai S, Gu J, Zhang G, Wang T. Hotspot detection and socio-ecological factor analysis of asthma hospitalization rate in Guangxi, China. ENVIRONMENTAL RESEARCH 2020; 183:109201. [PMID: 32050128 DOI: 10.1016/j.envres.2020.109201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/15/2020] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Asthma is a major public health concern throughout the world. Numerous researches have shown that the spatial-temporal patterns of asthma are inconsistent, leading to the suggestion that these patterns are determined by multiple factors. This study aims to detect spatial-temporal clusters of asthma and analyze socio-ecological factors associated with the asthma hospitalization rate in Guangxi, China. METHODS Asthma hospitalization and socio-ecological data for 88 counties/municipal districts in Guangxi, China in 2015 was collected. Space-time scan statistics were applied to identify the high-risk periods and areas of asthma hospital admissions. We further used GeoDetector and Spearman correlation coefficient to investigate the socio-ecological factors associated with the asthma hospitalization rates. RESULTS There were a total of 7804 asthma admissions in 2015. The high-risk period was from April to June. The age groups of 0-4 and ≥65 years were both at the highest risk, with hospital admission rates of 45.0/105 and 46.5/105, respectively. High-risk areas were found in central and western Guangxi with relative risk (RR) values of asthma hospitalizations greater than 2.0. GDP per capita and altitude were positively associated with asthma hospitalizations, while air pressure and wind speed had a negative association. The explanatory powers of these factors (i.e., GDP per capita, altitude, air pressure, wind speed) were 22%, 20%, 14% and 10%, respectively. CONCLUSIONS The GDP per capita appears to have the strongest correlation with asthma hospitalization rates. High-risk areas were identified in central and western Guangxi characterized by high GDP per capita. These findings may be helpful for authorities developing targeted asthma prevention policies for high-risk areas and vulnerable populations, especially during high-risk periods.
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Affiliation(s)
- Rui Ma
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
| | - Lizhong Liang
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
| | - Yunfeng Kong
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
| | - Shiyan Zhai
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
| | - Jiangyan Gu
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
| | - Guangli Zhang
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
| | - Tuanhui Wang
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004, China.
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Lee SW, Yon DK, James CC, Lee S, Koh HY, Sheen YH, Oh JW, Han MY, Sugihara G. Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: Age-stratified time-series analysis. J Allergy Clin Immunol 2019; 144:1542-1550.e1. [PMID: 31536730 DOI: 10.1016/j.jaci.2019.08.037] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs. OBJECTIVE We sought to examine the short-term effects in age-stratified groups (infants, preschool children, school-aged children, adults, and the elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on AEs. METHODS We performed an age-stratified analysis of the short-term effects of 4 groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis used a Poisson generalized linear regression model, with a distributed lag nonlinear model for identification of lagged and nonlinear effects and convergent cross-mapping for identification of causal associations. RESULTS Analysis of the total population (n = 10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly (relative risk [RR], 1.056-1.078 and 1.016, respectively) subjects. Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-aged children (RR, 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR, 1.026 and 1.044, respectively). Outdoor air pollutants (particulate matter of ≤10 μm in diameter, nitrogen dioxide, ozone, carbon monoxide, and sulfur dioxide) had significant short-term effects in all age groups (except for carbon monoxide and sulfur dioxide in infants). CONCLUSION These findings provide a need for the development of tailored strategies to prevent AE events in different age groups.
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Affiliation(s)
- Seung Won Lee
- Graduate School of Medicine, CHA University, Seongnam, Korea; Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Dong Keon Yon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea; Medical Corps, Republic of Korea Army, Seongnam, Korea
| | - Chase C James
- Scripps Institution of Oceanography, University of California San Diego, San Diego, Calif
| | - Shinhae Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyun Yong Koh
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Youn Ho Sheen
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
| | - George Sugihara
- Scripps Institution of Oceanography, University of California San Diego, San Diego, Calif
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Khan MD, Thi Vu HH, Lai QT, Ahn JW. Aggravation of Human Diseases and Climate Change Nexus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2799. [PMID: 31390751 PMCID: PMC6696070 DOI: 10.3390/ijerph16152799] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 01/24/2023]
Abstract
For decades, researchers have debated whether climate change has an adverse impact on diseases, especially infectious diseases. They have identified a strong relationship between climate variables and vector's growth, mortality rate, reproduction, and spatiotemporal distribution. Epidemiological data further indicates the emergence and re-emergence of infectious diseases post every single extreme weather event. Based on studies conducted mostly between 1990-2018, three aspects that resemble the impact of climate change impact on diseases are: (a) emergence and re-emergence of vector-borne diseases, (b) impact of extreme weather events, and (c) social upliftment with education and adaptation. This review mainly examines and discusses the impact of climate change based on scientific evidences in published literature. Humans are highly vulnerable to diseases and other post-catastrophic effects of extreme events, as evidenced in literature. It is high time that human beings understand the adverse impacts of climate change and take proper and sustainable control measures. There is also the important requirement for allocation of effective technologies, maintenance of healthy lifestyles, and public education.
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Affiliation(s)
- Mohd Danish Khan
- Resources Recycling Department, University of Science and Technology, (UST), 217, Gajeong-ro, Yuseong-gu, Daejeon-34113, Korea
- Center for Carbon Mineralization, Mineral Resources Research Division, Korea Institute of Geosciences and Mineral Resources (KIGAM), 124 Gwahak-ro, Yuseong-gu, Daejeon-34132, Korea
| | - Hong Ha Thi Vu
- Center for Carbon Mineralization, Mineral Resources Research Division, Korea Institute of Geosciences and Mineral Resources (KIGAM), 124 Gwahak-ro, Yuseong-gu, Daejeon-34132, Korea
| | - Quang Tuan Lai
- Resources Recycling Department, University of Science and Technology, (UST), 217, Gajeong-ro, Yuseong-gu, Daejeon-34113, Korea
- Center for Carbon Mineralization, Mineral Resources Research Division, Korea Institute of Geosciences and Mineral Resources (KIGAM), 124 Gwahak-ro, Yuseong-gu, Daejeon-34132, Korea
| | - Ji Whan Ahn
- Center for Carbon Mineralization, Mineral Resources Research Division, Korea Institute of Geosciences and Mineral Resources (KIGAM), 124 Gwahak-ro, Yuseong-gu, Daejeon-34132, Korea.
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Kumarihamy RMK, Tripathi NK. Geostatistical predictive modeling for asthma and chronic obstructive pulmonary disease using socioeconomic and environmental determinants. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:366. [PMID: 31254075 DOI: 10.1007/s10661-019-7417-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 03/20/2019] [Indexed: 06/09/2023]
Abstract
The spatial distribution of the prevalence of asthma and chronic obstructive pulmonary disease (COPD) remains under the influence of a wide array of environmental, climatic, and socioeconomic determinants. However, a large proportion of these influences remain unexplained. In completion, this study examined the spatial associations between asthma/COPD morbidity and their determinants using ordinary least squares (OLS) and geographically weighted regressions (GWR). Inpatient records collected from the secondary and tertiary care hospitals in Kandy from 2010 to 2014 were considered as the dependent variable. Potential risk factors (explanatory variables) were identified in four distinguished classes: 1) meteorological factors, (2) direct and indirect factors of air pollution, (3) socioeconomic factors, and (4) characteristics of the physical environment. All possible combinations of candidate explanatory variables were evaluated through an exploratory regression. A comparison between the regression models was also explored. The best OLS regression models revealed about 55% of asthma variation and 62% of COPD variation while GWR models yielded 78% and 74% of the variation of asthma and COPD occurrences respectively. Relative humidity, proximity to roads (0-200 m), road density, use of firewood as a source of fuel, and elevation play a vital role in predicting morbidity from asthma and COPD. Both local and global regression models are important in assessing spatial relationships of asthma and COPD. However, the local models exhibit a better prediction capability for assessing non-stationary relationships of asthma and COPD than global models. The geostatistical aspects used in this study may also provide insights for evaluating heterogeneous environmental risk factors in other epidemiological studies across different spatial settings.
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Affiliation(s)
- R M K Kumarihamy
- Remote Sensing and Geographic Information System AoS, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani, 12120, Thailand.
- Department of Geography, University of Peradeniya, Peradeniya, Sri Lanka.
| | - N K Tripathi
- Remote Sensing and Geographic Information System AoS, School of Engineering and Technology, Asian Institute of Technology, P.O. Box 4, Klong Luang, Pathumthani, 12120, Thailand
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Association of molds and metrological parameters to frequency of severe asthma exacerbation. Allergy Asthma Clin Immunol 2019; 15:29. [PMID: 31168304 PMCID: PMC6489181 DOI: 10.1186/s13223-019-0323-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/30/2019] [Indexed: 12/30/2022] Open
Abstract
Background Sensitization to airborne molds may be a risk factor for severe asthma and direct cause of asthma exacerbation (AE). Methods A prospective, 1-year (April 2016-March 2017) study, done in Kuwait Allergy Centre, investigated the link between AEs with exposure to outdoor molds and the role of meteorological parameters in mold sensitized patients and compared with non-allergic asthma patients who had asthma deterioration. The total of 676 adult asthmatics with moderate-severe AEs were included and divided into atopic (85.65%) and non-atopic group. Atopy was defined by positive skin prick test (SPT) to at least one inhalant allergen. Data regarding atopy and asthma severity were collected from patient's records. Patients with symptoms and signs of acute respiratory infection and patient sensitized to indoor allergens only were excluded. Daily count of local pollens (Salsola kali, Bermuda grass) and molds (Aspergillus, Alternaria and Cladosporium) were obtained from the Aerobiology department. Daily metrological parameters (atmospheric pressure-AP, temperature-T and relative humidity-RH) were provided by Kuwait Environment Public Authority. Count of spores/m3 and weather variable are shown on weekly basis. The year circle was divided into 4 Seasons (1, 2, 3, 4) accordingly to typical desert climate. Results Sensitization to molds was relatively high but significantly less (25.0%) if compared to the pollens sensitization. The highest number of AEs was in season 4 for both molds and pollens sensitized patients. Seasonal patterns for both allergens were significant and positively correlated with RH and AP. In season 1 only, mold sensitized patients showed higher rate of AEs. Non-atopic patients have been less sensitive to increased RH than atopic. Negative correlation with T was similar in both atopic and non-atopic patients. Conclusion Despite of high rate of sensitization to molds, their significant role in triggering AE was not found in desert environment. Typical desert climate and high allergencity of local weeds outweigh the influence of the molds.
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Gronlund CJ, Cameron L, Shea C, O’Neill MS. Assessing the magnitude and uncertainties of the burden of selected diseases attributable to extreme heat and extreme precipitation under a climate change scenario in Michigan for the period 2041-2070. Environ Health 2019; 18:40. [PMID: 31029138 PMCID: PMC6487044 DOI: 10.1186/s12940-019-0483-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 04/16/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND Extreme heat (EH) and extreme precipitation (EP) events are expected to increase with climate change in many parts of the world. Characterizing the potential future morbidity and mortality burden of EH and EP and associated costs, as well as uncertainties in the estimates, can identify areas for public health intervention and inform adaptation strategies. We demonstrate a burden of disease and uncertainty assessment using data from Michigan, USA, and provide approaches for deriving these estimates for locations lacking certain data inputs. METHODS Case-crossover analysis adapted from previous Michigan-specific modeling was used to characterize the historical EH-mortality relationship by county poverty rate and age group. Historical EH-associated hospitalization and emergency room visit risks from the literature were adapted to Michigan. In the U.S. Environmental Protection Agency's BenMAP software, we used a novel approach, with multiple spatially-varying exposures, to estimate all non-accidental mortality and morbidity occurring on EH days (EH days; days where maximum temperature 32.2-35 C or > 35 C) and EP days. We did so for two time periods: the "historical" period (1971-2000), and the "projected" period (2041-2070), by county. RESULTS The rate of all non-accidental mortality associated with EH days increased from 0.46/100,000 persons historically to 2.9/100,000 in the projected period, for 240 EH-attributable deaths annually. EH-associated ED visits increased from 12/100,000 persons to 68/100,000 persons, for 7800 EH-attributable emergency department visits. EP-associated ED visits increased minimally from 1.7 to 1.9/100,000 persons. Mortality and morbidity were highest among those aged 65+ (91% of all deaths). Projected health costs are dominated by EH-associated mortality ($280 million) and EH-associated emergency department visits ($14 million). A variety of sources contribute to a moderate-to-high degree of uncertainty around the point estimates, including uncertainty in the magnitude of climate change, population composition, baseline health rates, and exposure-response estimates. CONCLUSIONS The approach applied here showed that health burden due to climate may significantly rise for all Michigan counties by midcentury. The costs to health care and uncertainties in the estimates, given the potential for substantial attributable burden, provide additional information to guide adaptation measures for EH and EP.
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Affiliation(s)
- Carina J. Gronlund
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
| | - Lorraine Cameron
- Michigan Climate and Health Adaptation Program, Division of Environmental Health, Michigan Department of Health and Human Services, 333 S. Grand Ave, Lansing, MI 48909 USA
| | - Claire Shea
- Michigan Climate and Health Adaptation Program, Division of Environmental Health, Michigan Department of Health and Human Services, 333 S. Grand Ave, Lansing, MI 48909 USA
| | - Marie S. O’Neill
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
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Lam HCY, Hajat S, Chan EYY, Goggins WB. Different sensitivities to ambient temperature between first- and re-admission childhood asthma cases in Hong Kong - A time series study. ENVIRONMENTAL RESEARCH 2019; 170:487-492. [PMID: 30641275 DOI: 10.1016/j.envres.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/07/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Asthma can be triggered by various factors due to different etiologies. Environmental factors remain a common trigger of asthma, especially amongst children, and such ambient exposures can be harder to avoid compared to behavioral triggers. As such, the contribution of environmental factors may be enhanced when considering repeat asthma cases compared to initial presentations. To test this hypothesis, we assessed associations between ambient temperature and hospital admissions for asthma in Hong Kong and stratified admission records into first and repeat asthma hospitalizations. METHODS The daily number of asthma hospitalizations among children aged 0-5 years in Hong Kong during 2007-2011 was regressed on daily mean temperature using distributed lagged nonlinear models, with adjustment for seasonal patterns, day-of-week effects, and other meteorological factors and air-pollutants. Analyses were stratified by summer/winter and by type of admission (first admission and repeated admission). RESULTS About 33% of the 12284 asthma hospitalizations were repeat admissions. Repeat admissions demonstrated higher sensitivity to high temperature in the summer. During this period, high temperatures were associated with increased risk of repeat admission but not with first admissions: RR (95% CI) comparing 31 °C vs. 29 °C across lags 0-15 days was 3.40 (1.26, 9.18) and 0.74 (0.31, 1.77) for repeat and first admissions respectively. In the cold season, all admissions increased with falls in temperature, with slightly stronger associations apparent for repeat admissions compared to first admission: 1.20 (1.00, 1.44) vs. 1.10 (0.96, 1.26) respectively comparing risk at 15 °C vs. 12 °C across lags 0-5 days. CONCLUSIONS To our knowledge, this is the first study to show stronger associations between ambient temperature and repeat asthma admissions compared to first admissions. The higher sensitivity among those experiencing repeat admissions may allow for more personalized disease management. Given the substantial differences in associations by admission type, future studies of ambient exposures on asthma should consider analyzing the two groups separately.
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Affiliation(s)
- Holly Ching Yu Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, University of London, United Kingdom
| | - Emily Ying Yang Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Rice MB, Li W, Wilker EH, Gold DR, Schwartz J, Zanobetti A, Koutrakis P, Kloog I, Washko GR, O'Connor GT, Mittleman MA. Association of outdoor temperature with lung function in a temperate climate. Eur Respir J 2019; 53:13993003.00612-2018. [PMID: 30578386 DOI: 10.1183/13993003.00612-2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/25/2018] [Indexed: 01/07/2023]
Abstract
Acute exposure to cold dry air is a trigger of bronchoconstriction, but little is known about how daily outdoor temperature influences lung function.We investigated associations of temperature from a model using satellite remote sensing data with repeated measures of lung function among 5896 participants of the Framingham Heart Study Offspring and Third Generation cohorts residing in the Northeastern US. We further tested if temperature modified previously reported associations between pollution and lung function. We constructed linear mixed-effects models, and assessed departures from linearity using penalised splines.In fully adjusted linear models, 1-, 2- and 7-day average temperatures were all associated with lower lung function: each 5°C higher previous-week temperature was associated with a 20 mL lower (95% CI -34---6) forced expiratory volume in 1 s. There was significant effect modification by season: negative associations of temperature and lung function were present in winter and spring only. Negative associations between previous-day fine particulate matter and lung function were present during unseasonably warm but not unseasonably cool days, with a similar pattern for other pollutants.We speculate that temperature-related differences in lung function may be explained by behavioural changes on relatively warm days, which may increase outdoor exposures.
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Affiliation(s)
- Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Wenyuan Li
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Diane R Gold
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | | | - Itai Kloog
- Dept of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,The NHLBI's Framingham Heart Study, Framingham, MA, USA
| | - George T O'Connor
- The NHLBI's Framingham Heart Study, Framingham, MA, USA.,Pulmonary Center, Dept of Medicine, Boston University School of Medicine, Boston, MA, USA
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Iwade K, Shimoji S, Masaki H, Sakai T, Tanabe K, Goto N, Ohtsu F. [The Effectiveness of Counseling Using Preventative Informational Sheets with Climate and Environmental Data from Insurance Pharmacies in Preventing Worsened Asthma Symptoms]. YAKUGAKU ZASSHI 2018; 139:475-482. [PMID: 30518700 DOI: 10.1248/yakushi.18-00205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the possibility that having pharmacists give asthma patients informational sheets on climate and environmental changes at insurance pharmacies during patient counseling might prevent the worsening of asthma symptoms. Patients with hyperlipidemia were comparative subjects. We created informational sheets about climate and environmental changes and their influence on asthma. During patient counseling, pharmacists gave them to all asthma patients who visited insurance pharmacies over a period of 2 months, between November and December 2017. Based on previous studies, we called days which showed certain climate or environmental changes as compared to the previous day "change days". We compared the number of visiting patients on change days after preventative information was provided (between January and March 2018) with the number before information was provided (between January and March 2017). In addition, we compared those numbers with the number of patients who visited the target pharmacies between January and March 2016 in order to examine the influence of yearly climate change. The same procedure was used with hyperlipidemic patients. The number of visiting asthma patients after information was provided significantly decreased (5.1±2.1, p=0.03) compared with the number before information was provided, between January and March 2017 (6.1±2.8). The number of aforementioned visits compared to those between January and March 2016 also significantly decreased (p=0.01). Our results suggest that preventative information about climate and environmental changes provided by pharmacists during patient counseling might influence the number of asthma patient visits and prevent the exacerbation of their symptoms.
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Affiliation(s)
- Kentaro Iwade
- Drug Informatics, Faculty of Pharmacy, Meijo University.,Saera Pharmacy
| | | | | | | | | | - Nobuyuki Goto
- Drug Informatics, Faculty of Pharmacy, Meijo University
| | - Fumiko Ohtsu
- Drug Informatics, Faculty of Pharmacy, Meijo University
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Simba J, Marete I, Waihenya R, Kombe Y, Mwangi A, Mburugu P, Ogaro F. Knowledge and perceptions on childhood asthma among care-takers of children with asthma at a National Referral Hospital in Western Kenya: a descriptive study. Afr Health Sci 2018; 18:965-971. [PMID: 30766561 PMCID: PMC6354861 DOI: 10.4314/ahs.v18i4.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Identifying knowledge gaps in asthma self-management and identifying existing myths is an important step in determining appropriate health education and demystifying the myths so as to enhance asthma control. Objective To identify existing knowledge gaps and perceptions among the caregivers of asthmatic children. Methods A cross sectional study was done among caretakers of asthmatic children aged 6–11 years at Moi Teaching and Referral Hospital. Data on knowledge and perceptions among caretakers was collected using a questionnaire. Results A total of 116 caretakers were recruited of whom 71.6% were mothers. Although 60% of the caretakers had asthma medications at home, only a third felt their children were asthmatic. Eighty four (72.4%) had basic asthma knowledge. Syrups were preferred to inhalers by 70.7%, with 64.7% believing that inhalers were for the very sick. Only 36 (31%) felt preventer medications in asthma were necessary. Acceptance of asthma as a diagnosis and presence of asthma drugs were significantly associated with better knowledge of asthma, p-values 0.015 and 0.009 respectively. Conclusion Most caregivers perceive syrups to be better despite having good basic knowledge on asthma. There is need to address asthma perceptions among caretakers in resource poor settings which is likely to improve control.
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Affiliation(s)
- Justus Simba
- Jomo Kenyatta University of Agriculture and Technology, Child Health and Paediatrics
| | - Irene Marete
- Moi University School of Medicine, Child Health and Paediatrics
| | | | | | - Ann Mwangi
- Moi University School of Medicine, Behavioural Sciences
| | - Patrick Mburugu
- Jomo Kenyatta University of Agriculture and Technology, Child Health and Paediatrics
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Yu X, Feric Z, Cordero JF, Meeker JD, Alshawabkeh A. Potential influence of temperature and precipitation on preterm birth rate in Puerto Rico. Sci Rep 2018; 8:16106. [PMID: 30382121 PMCID: PMC6208375 DOI: 10.1038/s41598-018-34179-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/12/2018] [Indexed: 11/21/2022] Open
Abstract
The preterm birth (PTB) rate for singletons born in the tropical Caribbean island Puerto Rico increased from 11.3% in 1994, which was comparable to rates in the U.S., to as high as 18.3% in 2006 before decreasing to 15.5% in 2012. A few studies have reported that weather extremes are associated with higher risk of preterm birth, however, the effects of ambient temperature and precipitation has not been well examined in Puerto Rico. We compiled child birth data from the National Center for Health Statistics and weather data from the National Oceanic and Atmospheric Administration from 1994 to 2012. We explored the association between the weather factors and PTB rates with a distributed lag non-linear model (DLNM). We did not find direct association of lagged effect of temperature on birth outcome over monthly timescales. Both high intensity and frequency of precipitation and high frequency of storm and flood events are associated with increased risk of PTB rates. While the weather factors do not explain the marked increase and decrease in PTB rate, we emphasize the negative effects on PTB from weather extremes particularly precipitation in Puerto Rico.
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Affiliation(s)
- Xue Yu
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Zlatan Feric
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
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Davis RE, Enfield KB. Respiratory hospital admissions and weather changes: a retrospective study in Charlottesville, Virginia, USA. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:1015-1025. [PMID: 29417216 DOI: 10.1007/s00484-018-1503-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 05/24/2023]
Abstract
In most midlatitude locations, human morbidity and mortality are highly seasonal, with winter peaks driven by respiratory disease and associated comorbidities. But the transition between high and low mortality/morbidity months varies spatially. We use a measure of the thermal biophysical strain imposed on the respiratory system-the Acclimatization Thermal Strain Index (ATSI)-to examine respiratory hospital admissions in Charlottesville, VA. Daily respiratory admissions to the University of Virginia over a 19-year period are compared to ATSI values derived from hourly surface weather data acquired from the Charlottesville airport. Negative ATSI values (associated with transitions from warm (and humid) to cold (and dry) conditions) are related to admission peaks at seasonal and weekly timescales, whereas positive ATSI values (cold to warm) exhibit weaker relationships. This research marks the first application of the ATSI to human morbidity, and results suggest that respiratory strain may account for how people who are acclimated to different climates respond to short-term weather changes.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, Charlottesville, VA, 22904-4123, USA.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA, 22908, USA
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Xu Z, Crooks JL, Davies JM, Khan AF, Hu W, Tong S. The association between ambient temperature and childhood asthma: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:471-481. [PMID: 29022096 DOI: 10.1007/s00484-017-1455-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/18/2017] [Accepted: 09/24/2017] [Indexed: 05/09/2023]
Abstract
The objectives of this study are to review available information on the association between ambient temperature and childhood asthma, and to elucidate the possible underlying mechanisms of this relationship. A systematic review was conducted based on the papers retrieved from four databases, including PubMed, ProQuest, ScienceDirect, and Scopus. Papers examining the association of absolute temperature or temperature variation with childhood asthma published from 1 January 2000 to 31 December 2016 were included. Thirteen papers have quantified the effect of absolute temperature on childhood asthma, and six papers have examined the effect of intra- or inter-day temperature variation on childhood asthma. All studies were conducted in urban areas. Aeroallergen sensitizations were only considered in the analyses of one study. Discrepancy existed in the significance of the relationship between absolute temperature and childhood asthma, and also in the shape of this relationship (i.e. linear or non-linear) and whether temperature effects were lagged. Increasing evidence is suggesting non-linear relationship between absolute temperature and childhood asthma. Future research should investigate the burden of childhood asthma specifically attributable to extreme temperatures and temperature variation using advanced statistical approach, particularly in rural areas, after properly considering aeroallergens and air pollution. Projecting future burden of childhood asthma under climate change scenarios is also warranted.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia.
| | | | - Janet Mary Davies
- School of Biomedical Sciences & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Al Fazal Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
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Collaco JM, Appel LJ, McGready J, Cutting GR. The relationship of lung function with ambient temperature. PLoS One 2018; 13:e0191409. [PMID: 29346418 PMCID: PMC5773195 DOI: 10.1371/journal.pone.0191409] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/04/2018] [Indexed: 11/25/2022] Open
Abstract
Background Lung function is complex trait with both genetic and environmental factors contributing to variation. It is unknown how geographic factors such as climate affect population respiratory health. Objective To determine whether ambient air temperature is associated with lung function (FEV1) in the general population. Design/Setting Associations between spirometry data from two National Health and Nutrition Examination Survey (NHANES) periods representative of the U.S. non-institutionalized population and mean annual ambient temperature were assessed using survey-weighted multivariate regression. Participants/Measurements The NHANES III (1988–94) cohort included 14,088 individuals (55.6% female) and the NHANES 2007–12 cohort included 14,036 individuals (52.3% female), with mean ages of 37.4±23.4 and 34.4±21.8 years old and FEV1 percent predicted values of 99.8±15.8% and 99.2±14.5%, respectively. Results After adjustment for confounders, warmer ambient temperatures were associated with lower lung function in both cohorts (NHANES III p = 0.020; NHANES 2007–2012 p = 0.014). The effect was similar in both cohorts with a 0.71% and 0.59% predicted FEV1 decrease for every 10°F increase in mean temperature in the NHANES III and NHANES 2007–2012 cohorts, respectively. This corresponds to ~2 percent predicted difference in FEV1 between the warmest and coldest regions in the continental United States. Conclusions In the general U.S. population, residing in regions with warmer ambient air temperatures was associated with lower lung function with an effect size similar to that of traffic pollution. Rising temperatures associated with climate change could have effects on pulmonary function in the general population.
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Affiliation(s)
- Joseph M. Collaco
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| | - Lawrence J. Appel
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - John McGready
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Garry R. Cutting
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Abstract
Climate change is the greatest global health threat of the twenty-first century, yet it is not widely understood as a health hazard by primary care providers in the United States. Aside from increasing displacement of populations and acute trauma resulting from increasing frequency of natural disasters, the impact of climate change on temperature stress, vector-borne illnesses, cardiovascular and respiratory illnesses, and mental health is significant, with disproportionate impact on underserved and marginalized populations. Primary care providers must be aware of the impact of climate change on the health of their patients and advocate for adaptation and mitigation policies for the populations they serve.
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Jo EJ, Lee WS, Jo HY, Kim CH, Eom JS, Mok JH, Kim MH, Lee K, Kim KU, Lee MK, Park HK. Effects of particulate matter on respiratory disease and the impact of meteorological factors in Busan, Korea. Respir Med 2017; 124:79-87. [PMID: 28284326 DOI: 10.1016/j.rmed.2017.02.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/28/2017] [Accepted: 02/12/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Both air pollution and weather impact hospitalization for respiratory diseases. However, few studies have investigated the contribution of weather to hospitalization related to the adverse effects of air pollution. This study analyzed the effects of particulate matter (PM) on daily respiratory-related hospital admissions, taking into account meteorological factors. METHODS Daily hospital admissions for respiratory diseases (acute bronchitis, allergic rhinitis, and asthma) between 2007 and 2010 were extracted from the National Health Insurance Corporation, Korea. Patients were divided into three age-based groups (0-15, 16-64, and ≥65 years). PM levels were obtained from 19 monitoring stations in Busan. RESULTS The mean number of patients admitted for acute bronchitis, allergic rhinitis, and asthma was 5.8 ± 11.9, 4.4 ± 6.1, and 3.3 ± 3.3, respectively. During that time, the daily mean PM10 and PM2.5 concentrations were 49.6 ± 20.5 and 24.2 ± 10.9 μg/m3, respectively. The mean temperature anomaly was 7.0 ± 2.3 °C; the relative humidity was 62.0 ± 18.0%. Hospital admission rates for respiratory diseases increased with increasing PM and temperature, and with decreasing relative humidity. A multivariate analysis including PM, temperature anomaly, relative humidity, and age showed a significant increase in respiratory-related admissions with increasing PM levels and a decreasing relative humidity. Higher PM2.5 levels had a greater effect on respiratory-related hospital admission than did PM10 levels. Children and the elderly were the most susceptible to hospital admission for respiratory disease. CONCLUSIONS PM levels and meteorological factors impacted hospitalization for respiratory diseases, especially in children and the elderly. The effect of PM on respiratory diseases increased as the relative humidity decreased.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Woo-Seop Lee
- Climate Research Department, APEC Climate Center, Busan, South Korea
| | - Hyun-Young Jo
- Climate Research Department, APEC Climate Center, Busan, South Korea; Department of Atmospheric Sciences, Pusan National University, Busan, South Korea
| | - Chang-Hoon Kim
- Department of Preventive Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Jung-Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeong-Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ki-Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Min-Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
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Shulman BS, Marcano AI, Davidovitch RI, Karia R, Egol KA. Nature's wrath-The effect of weather on pain following orthopaedic trauma. Injury 2016; 47:1841-6. [PMID: 27318614 DOI: 10.1016/j.injury.2016.05.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/29/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite frequent complaints by orthopaedic trauma patients, to our knowledge there is no data regarding weather's effect on pain and function following acute and chronic fracture. The aim of our study was to investigate the influence of daily weather conditions on patient reported pain and functional status. METHODS We retrospectively examined prospectively collected data from 2369 separate outpatient visits of patients recovering from operative management of acute tibial plateau fractures, acute distal radius fractures, and chronic fracture nonunions. Pain and functional status were assessed using a visual analogue scale (VAS) and the DASH and SMFA functional indexes. For each visit date, the mean temperature, difference between mean temperature and expected temperature, dew point, mean humidity, amount of rain, amount of snow, and barometric pressure were recorded. Statistical analysis was run to search for associations between weather data and patient reported pain and function. RESULTS Low barometric pressure was associated with increased pain across all patient visits (p=0.007) and for patients at 1-year follow-up only (p=0.005). At 1-year follow-up, high temperature (p=0.021) and high humidity (p=0.030) were also associated with increased pain. No significant association was noted between weather data and patient reported functional status at any follow-up interval. CONCLUSIONS Patient complaints of weather influencing pain after orthopaedic trauma are valid. While pain in the immediate postoperative period is most likely dominated by incisional and soft tissue injuries, as time progresses barometric pressure, temperature, and humidity impact patient pain levels. Affirming and counseling that pain may vary based on changing weather conditions can help manage patient expectations and improve satisfaction.
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Affiliation(s)
- Brandon S Shulman
- NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA.
| | - Alejandro I Marcano
- NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA.
| | - Roy I Davidovitch
- Center for Musculoskeletal Care, 33 East 38th Street, New York, NY 10016, USA.
| | - Raj Karia
- NYU Langone Medical Center, 380 2nd Ave. Suite 606, New York, NY 10010, USA.
| | - Kenneth A Egol
- NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA.
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Johnson LH, Chambers P, Dexheimer JW. Asthma-related emergency department use: current perspectives. Open Access Emerg Med 2016; 8:47-55. [PMID: 27471415 PMCID: PMC4950546 DOI: 10.2147/oaem.s69973] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Asthma is one of the most common chronic pediatric diseases. Patients with asthma often present to the emergency department for treatment for acute exacerbations. These patients may not have a primary care physician or primary care home, and thus are seeking care in the emergency department. Asthma care in the emergency department is multifaceted to treat asthma patients appropriately and provide quality care. National and international guidelines exist to help drive clinical care. Electronic and paper-based tools exist for both physicians and patients to help improve emergency, home, and preventive care. Treatment of patients with asthma should include the acute exacerbation, long-term management of controller medications, and controlling triggers in the home environment. We will address the current state of asthma research in emergency medicine in the US, and discuss some of the resources being used to help provide a medical home and improve care for patients who suffer from acute asthma exacerbations.
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Affiliation(s)
| | | | - Judith W Dexheimer
- Division of Emergency Medicine; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Lam HCY, Li AM, Chan EYY, Goggins WB. The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax 2016; 71:1097-1109. [PMID: 27343213 DOI: 10.1136/thoraxjnl-2015-208054] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 05/20/2016] [Accepted: 06/06/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have found associations between meteorological variables and asthma hospitalisations but the nature of these associations has varied and few studies have been done in subtropical areas or evaluated effect modification by age. OBJECTIVES This study aimed to evaluate associations between asthma hospitalisations and meteorological factors and to assess effect modification of these associations by age and season in Hong Kong. METHODS Poisson generalised additive models combined with distributed lag nonlinear models and piecewise linear models were used to model associations between daily asthma hospitalisations from 2004 to 2011 and meteorological factors and air pollutants, adjusting for day of week, seasonality and trend. Subgroup analyses by age and season were performed. RESULTS In the hot season, hospitalisations were lowest at 27°C, rose to a peak at 30°C, then plateaued between 30°C and 32°C. The cumulative relative risk for lags 0-3 days (RRlag0-3) for 30°C vs 27°C was 1.19 (95% CI 1.06 to 1.34). In the cold season, temperature was negatively associated with asthma hospitalisations. The cumulative RRlag0-3 for 12°C vs 25°C was 1.33 (95% CI 1.13 to 1.58). Adult admissions were most sensitive to temperatures in both seasons while admissions among children under 5 were least associated. Higher humidity and ozone levels in the hot season, and low humidity in the cold season were also associated with more asthma admissions. CONCLUSIONS People with asthma should avoid exposure to adverse conditions by limiting outdoor activities during periods of extreme temperatures, combinations of high humidity and high temperature, and low humidity and low temperature, and high ozone levels.
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Affiliation(s)
- Holly Ching-Yu Lam
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Albert Martin Li
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Emily Ying-Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Soneja S, Jiang C, Fisher J, Upperman CR, Mitchell C, Sapkota A. Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A. Environ Health 2016; 15:57. [PMID: 27117324 PMCID: PMC4847234 DOI: 10.1186/s12940-016-0142-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/22/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012. METHODS We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma (ICD-9 code 493, n = 115,923). RESULTS Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds. CONCLUSION Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.
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Affiliation(s)
- Sutyajeet Soneja
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Jared Fisher
- Department of Epidemiology, University of Maryland School of Public Health, College Park, 20742, MD, USA
| | - Crystal Romeo Upperman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Clifford Mitchell
- Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Baltimore, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA.
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44
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Zhang J, Dai J, Yan L, Fu W, Yi J, Chen Y, Liu C, Xu D, Wang Q. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2935163. [PMID: 27556031 PMCID: PMC4983328 DOI: 10.1155/2016/2935163] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/13/2022]
Abstract
Background. Prevalence of childhood asthma varies significantly among regions, while its reasons are not clear yet with only a few studies reporting relevant causes for this variation. Objective. To investigate the potential role of city-average levels of air pollutants and climatic factors in order to distinguish differences in asthma prevalence in China and explain their reasons. Methods. Data pertaining to 10,777 asthmatic patients were obtained from the third nationwide survey of childhood asthma in China's urban areas. Annual mean concentrations of air pollutants and other climatic factors were obtained for the same period from several government departments. Data analysis was implemented with descriptive statistics, Pearson correlation coefficient, and multiple regression analysis. Results. Pearson correlation analysis showed that the situation of childhood asthma was strongly linked with SO2, relative humidity, and hours of sunshine (p < 0.05). Multiple regression analysis indicated that, among the predictor variables in the final step, SO2 was found to be the most powerful predictor variable amongst all (β = -19.572, p < 0.05). Furthermore, results had shown that hours of sunshine (β = -0.014, p < 0.05) was a significant component summary predictor variable. Conclusion. The findings of this study do not suggest that air pollutants or climate, at least in terms of children, plays a major role in explaining regional differences in asthma prevalence in China.
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Affiliation(s)
- Juanjuan Zhang
- Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China
| | - Jihong Dai
- Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- *Jihong Dai:
| | - Li Yan
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Wenlong Fu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Jing Yi
- Department of Medical Statistics, Chongqing Medical University, Chongqing 400046, China
| | - Yuzhi Chen
- Center for Asthma Prevalence and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Chuanhe Liu
- Center for Asthma Prevalence and Education, Capital Institute of Pediatrics, Beijing 100020, China
| | - Dongqun Xu
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qiang Wang
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Lin YJ, Lin RL, Khosravi M, Lee LY. Hypersensitivity of vagal pulmonary C-fibers induced by increasing airway temperature in ovalbumin-sensitized rats. Am J Physiol Regul Integr Comp Physiol 2015; 309:R1285-91. [PMID: 26333786 DOI: 10.1152/ajpregu.00298.2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/26/2015] [Indexed: 11/22/2022]
Abstract
Our recent study has shown that hyperventilation of humidified warm air (HWA) triggered cough and reflex bronchoconstriction in patients with mild asthma. We suggested that a sensitizing effect on bronchopulmonary C-fibers by increasing airway temperature was involved, but direct evidence was lacking. This study was carried out to test the hypothesis that HWA enhances the pulmonary C-fiber sensitivity in Brown-Norway rats sensitized with ovalbumin (Ova). In anesthetized rats, isocapnic hyperventilation of HWA for 3 min rapidly elevated airway temperature to a steady state of 41.7°C. Immediately after the HWA challenge, the baseline fiber activity (FA) of pulmonary C-fibers was markedly elevated in sensitized rats, but not in control rats. Furthermore, the response of pulmonary C-fibers to right atrial injection of capsaicin in sensitized rats was significantly higher than control rats before the HWA challenge, and the response to capsaicin was further amplified after HWA in sensitized rats (ΔFA = 4.51 ± 1.02 imp/s before, and 9.26 ± 1.74 imp/s after the HWA challenge). A similar pattern of the HWA-induced potentiation of the FA response to phenylbiguanide, another chemical stimulant of C-fibers, was also found in sensitized rats. These results clearly demonstrated that increasing airway temperature significantly elevated both the baseline activity and responses to chemical stimuli of pulmonary C-fibers in Ova-sensitized rats. In conclusion, this study supports the hypothesis that the increased excitability of these afferents may have contributed to the cough and reflex bronchoconstriction evoked by hyperventilation of HWA in patients with asthma.
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Affiliation(s)
| | | | - Mehdi Khosravi
- Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky
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46
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Tibbetts JH. Air quality and climate change: a delicate balance. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:A148-53. [PMID: 26030069 PMCID: PMC4455574 DOI: 10.1289/ehp.123-a148] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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47
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Yamazaki S, Shima M, Yoda Y, Oka K, Kurosaka F, Shimizu S, Takahashi H, Nakatani Y, Nishikawa J, Fujiwara K, Mizumori Y, Mogami A, Yamada T, Yamamoto N. Exposure to air pollution and meteorological factors associated with children's primary care visits at night due to asthma attack: case-crossover design for 3-year pooled patients. BMJ Open 2015; 5:e005736. [PMID: 25941174 PMCID: PMC4420953 DOI: 10.1136/bmjopen-2014-005736] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We examined the association of outdoor air pollution and meteorological parameters with primary care visits (PCVs) at night due to asthma attack. SETTING A case-crossover study was conducted in a primary care clinic in Himeji City, Japan. PARTICIPANTS Participants were 1447 children aged 0-14 years who visited the clinic with an asthma attack from April 2010 until March 2013. EXPOSURE Daily concentrations of air pollutants and meteorological parameters were measured. PRIMARY OUTCOME PCVs at night due to asthma attack. A conditional logistic regression model was used to estimate ORs of PCVs per unit increment of air pollutants or meteorological parameters (the per-unit increments of particulate matter with an aerodynamic diameter ≤2.5 µm (PM₂.₅) and ozone were 10 μg/m(3) and 10 ppb, respectively). Analyses took into consideration the effects of seasonality. RESULTS We noted an association between PCVs and daily ozone levels on the day before a PCV (OR=1.17; 95% CI 1.01 to 1.35; p=0.04), as well as between PCVs and 3-day mean ozone levels before a PCV (OR=1.29; 95% CI 1.00 to 1.46; p=0.04), from April until June. We also observed an association between PCVs and daily PM₂.₅ levels on the day before a PCV from December until March (OR=1.16; 95% CI 1.01 to 1.33; p=0.05). Meteorological parameters, such as hours of sunshine from September until November, atmospheric pressure from April until June, and temperature from April until August, were also found to be associated with PCVs. CONCLUSIONS The findings in the present study supported an association between ozone and PCVs and suggest that certain meteorological items may be associated with PCVs.
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Affiliation(s)
- Shin Yamazaki
- Department of Environmental Epidemiology, National Institute for Environmental Studies, Tsukuba, Japan
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshiko Yoda
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Japan
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Karimi P, Peters KO, Bidad K, Strickland PT. Polycyclic aromatic hydrocarbons and childhood asthma. Eur J Epidemiol 2015; 30:91-101. [PMID: 25600297 DOI: 10.1007/s10654-015-9988-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 01/05/2015] [Indexed: 11/25/2022]
Abstract
Asthma is the most common chronic illness in children living in developed countries and the leading cause of childhood hospitalization and school absenteeism. Prevalence rates of asthma are increasing and show disparities across gender, geographic regions, and ethnic/racial groups. Common risk factors for developing childhood asthma include exposure to tobacco smoke, previous allergic reactions, a family history of asthma, allergic rhinitis or eczema, living in an urban environment, obesity and lack of physical exercise, severe lower respiratory tract infections, and male gender. Asthma exacerbation in children can be triggered by a variety of factors, including allergens (e.g., pollen, dust mites, and animal dander), viral and bacterial infections, exercise, and exposure to airway irritants. Recent studies have shown that exposure to polycyclic aromatic hydrocarbons (PAHs), a major component of fine particulate matter from combustion sources, is also associated with onset of asthma, and increasing asthmatic symptoms. In this paper, we review sources of childhood PAH exposure and the association between airborne PAH exposure and childhood asthma prevalence and exacerbation.
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Affiliation(s)
- Parisa Karimi
- Program in Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E7535, Baltimore, MD, USA
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Hervás D, Utrera JF, Hervás-Masip J, Hervás JA, García-Marcos L. Can meteorological factors forecast asthma exacerbation in a paediatric population? Allergol Immunopathol (Madr) 2015; 43:32-6. [PMID: 24168972 DOI: 10.1016/j.aller.2013.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 07/06/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Asthma exacerbations attended in emergency departments show a marked seasonality in the paediatric age. This seasonal pattern can change from one population to another and the factors involved are poorly understood. OBJECTIVES To evaluate the association between meteorological factors and schooling with asthma exacerbations in children attended in the paediatric emergency department of a district hospital. METHODS We conducted a retrospective review of the medical records of children 5-14 years of age attended for asthma exacerbations during a 4-year period (2007-2011). Climatic data were obtained from a weather station located very close to the population studied. The number of asthma exacerbations was correlated to temperature, barometric pressure, relative humidity, rainfall, wind speed, wind distance, solar radiation, water vapour pressure and schooling, using regression analyses. RESULTS During the study period, 371 children were attended for asthma exacerbations; median age was eight years (IQR: 6-11), and 59% were males. Asthma exacerbations showed a bimodal pattern with peaks in spring and summer. Maximum annual peak occurred in week 39, within 15 days from school beginning after the summer holidays. A regression model with mean temperature, water vapour pressure, relative humidity, maximum wind speed and schooling could explain 98.4% (p<0.001) of monthly asthma exacerbations. CONCLUSIONS The combination of meteorological factors and schooling could predict asthma exacerbations in children attended in a paediatric emergency department.
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Affiliation(s)
- D Hervás
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain; Department of Paediatrics, Inca Hospital, Mallorca Spain.
| | - J F Utrera
- Department of Paediatrics, Inca Hospital, Mallorca Spain
| | - J Hervás-Masip
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain
| | - J A Hervás
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain
| | - L García-Marcos
- Respiratory Medicine and Allergy Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Spain
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50
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Franchini M, Mannucci PM. Impact on human health of climate changes. Eur J Intern Med 2015; 26:1-5. [PMID: 25582074 DOI: 10.1016/j.ejim.2014.12.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/17/2014] [Accepted: 12/23/2014] [Indexed: 01/25/2023]
Abstract
There is increasing evidence that climate is rapidly changing. These changes, which are mainly driven by the dramatic increase of greenhouse gas emissions from anthropogenic activities, have the potential to affect human health in several ways. These include a global rise in average temperature, an increased frequency of heat waves, of weather events such as hurricanes, cyclones and drought periods, plus an altered distribution of allergens and vector-borne infectious diseases. The cardiopulmonary system and the gastrointestinal tract are particularly vulnerable to the adverse effects of global warming. Moreover, some infectious diseases and their animal vectors are influenced by climate changes, resulting in higher risk of typhus, cholera, malaria, dengue and West Nile virus infection. On the other hand, at mid latitudes warming may reduce the rate of diseases related to cold temperatures (such as pneumonia, bronchitis and arthritis), but these benefits are unlikely to rebalance the risks associated to warming.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | - Pier Mannuccio Mannucci
- Scientific Direction, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy.
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