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Chiner E, Machetti C, Boira I, Esteban V, Castelló Faus C, Torba Kordyukova A. Analysis of Patients Admitted for Asthma Exacerbation in a Tertiary Hospital in Spain. Cureus 2024; 16:e63042. [PMID: 39050304 PMCID: PMC11268450 DOI: 10.7759/cureus.63042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES To analyze the characteristics of adult patients admitted for asthma exacerbation and determine optimization, treatment adherence, and follow-up in clinics. METHODS Patients ≥ 18 years old admitted from May 2021 to June 2023 with a primary diagnosis of asthma exacerbation were included. Patients with a secondary diagnosis of asthma exacerbation and those without a confirmed diagnosis were excluded. RESULTS A total of 186 patients were analyzed, 63% were female, with a mean age of 49 ± 34 years, mean body mass index (BMI) of 26.4 ± 5 kg/m2, mean immunoglobulin E level of 132 ± 235 IU/mL (range: 25-2041), mean eosinophils count of 180 ± 443, and length of stay of 8.6 ± 5 days. Comparing patients with one admission to those with multiple admissions, differences were observed in age (39 ± 15 vs. 58 ± 20, p < 0.0001), BMI (25.2 ± 3 vs. 27.4 ± 4, p < 0.0003), comorbidity (15% vs. 60%, p < 0.0001), and length of stay (4.5 ± 2 vs. 11 ± 3, p < 0.0001). Of the patients, 15% had undiagnosed asthma, 28% had known asthma without maintenance therapy, 23% were managed by primary care, and 34% were followed by pneumology. The mean Test of Adherence to Inhalers (TAI) score was 42.5 ± 8 points, with 70% showing erratic non-adherence, 46% showing deliberate non-adherence, and 21% showing unconscious non-adherence. CONCLUSIONS The young population represents a significant percentage of admissions for asthma exacerbation due to poor follow-up in pulmonology clinics, inadequate treatment optimization, and low adherence. This study adds that it is necessary to improve the approach to asthma in primary care to optimize treatment, reduce under-diagnosis, and avoid hospital admissions.
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Affiliation(s)
- Eusebi Chiner
- Pulmonology, Hospital Universitario San Juan de Alicante, Alicante, ESP
| | - Clara Machetti
- Pulmonology, Hospital Universitario San Juan de Alicante, Alicante, ESP
| | - Ignacio Boira
- Pulmonology, Hospital Universitario San Juan de Alicante, Alicante, ESP
| | - Violeta Esteban
- Pulmonology, Hospital Universitario San Juan de Alicante, Alicante, ESP
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Wang W, Gulliver J, Beevers S, Freni Sterrantino A, Davies B, Atkinson RW, Fecht D. Short-Term Nitrogen Dioxide Exposure and Emergency Hospital Admissions for Asthma in Children: A Case-Crossover Analysis in England. J Asthma Allergy 2024; 17:349-359. [PMID: 38623450 PMCID: PMC11016460 DOI: 10.2147/jaa.s448600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/12/2024] [Indexed: 04/17/2024] Open
Abstract
Background There is an increasing body of evidence associating short-term ambient nitrogen dioxide (NO2) exposure with asthma-related hospital admissions in children. However, most studies have relied on temporally resolved exposure information, potentially ignoring the spatial variability of NO2. We aimed to investigate how daily NO2 estimates from a highly resolved spatio-temporal model are associated with the risk of emergency hospital admission for asthma in children in England. Methods We conducted a time-stratified case-crossover study including 111,766 emergency hospital admissions for asthma in children (aged 0-14 years) between 1st January 2011 and 31st December 2015 in England. Daily NO2 levels were predicted at the patients' place of residence using spatio-temporal models by combining land use data and chemical transport model estimates. Conditional logistic regression models were used to obtain the odds ratios (OR) and confidence intervals (CI) after adjusting for temperature, relative humidity, bank holidays, and influenza rates. The effect modifications by age, sex, season, area-level income deprivation, and region were explored in stratified analyses. Results For each 10 µg/m³ increase in NO2 exposure, we observed an 8% increase in asthma-related emergency admissions using a five-day moving NO2 average (mean lag 0-4) (OR 1.08, 95% CI 1.06-1.10). In the stratified analysis, we found larger effect sizes for male (OR 1.10, 95% CI 1.07-1.12) and during the cold season (OR 1.10, 95% CI 1.08-1.12). The effect estimates varied slightly by age group, area-level income deprivation, and region. Significance Short-term exposure to NO2 was significantly associated with an increased risk of asthma emergency admissions among children in England. Future guidance and policies need to consider reflecting certain proven modifications, such as using season-specific countermeasures for air pollution control, to protect the at-risk population.
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Affiliation(s)
- Weiyi Wang
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
| | - John Gulliver
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Sean Beevers
- MRC Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, London, UK
| | - Anna Freni Sterrantino
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- The Alan Turing Institute, London, UK
| | - Bethan Davies
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
| | - Richard W Atkinson
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health and Care Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, London, UK
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Han A, Deng S, Yu J, Zhang Y, Jalaludin B, Huang C. Asthma triggered by extreme temperatures: From epidemiological evidence to biological plausibility. ENVIRONMENTAL RESEARCH 2023; 216:114489. [PMID: 36208788 DOI: 10.1016/j.envres.2022.114489] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is rapidly growing evidence indicating that extreme temperature is a crucial trigger and potential activator of asthma; however, the effects of extreme temperature on asthma are inconsistently reported and the its potential mechanisms remain undefined. OBJECTIVES This review aims to estimate the impacts of extreme heat, extreme cold, and temperature variations on asthma by systematically summarizing the existing studies from epidemiological evidence to biological plausibility. METHODS We conducted a systematic search in PubMed, Embase, and Web of Science from inception to June 30, 2022, and we retrieved articles of epidemiology and biological studies which assessed associations between extreme temperatures and asthma. This protocol was registered with PROSPERO (CRD42021273613). RESULTS From 12,435 identified records, 111 eligible studies were included in the qualitative synthesis, and 37 articles were included in the meta-analysis (20 for extreme heat, 16 for extreme cold, and 15 for temperature variations). For epidemiological evidence, we found that the synergistic effects of extreme temperatures, indoor/outdoor environments, and individual vulnerabilities are important triggers for asthma attacks, especially when there is extreme heat or cold. Meta-analysis further confirmed the associations, and the pooled relative risks for asthma attacks in extreme heat and extreme cold were 1.07 (95%CI: 1.03-1.12) and 1.20 (95%CI: 1.12-1.29), respectively. Additionally, this review discussed the potential inflammatory mechanisms behind the associations between extreme temperatures and asthma exacerbation, and highlighted the regulatory role of immunological pathways and transient receptor potential ion channels in asthma triggered by extreme temperatures. CONCLUSIONS We concluded that both extreme heat and cold could significantly increase the risk of asthma. Additionally, we proposed a potential mechanistic framework, which is important for understanding the disease pathogenesis that uncovers the complex mechanisms of asthma triggered by extreme temperatures and protects the sensitive individuals from impacts of extreme weather events and climate change.
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Affiliation(s)
- Azhu Han
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shizhou Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiarui Yu
- Shenzhen Health Development Research and Data Management Center, Shenzhen 518028, China, School of Arts and Sciences, Columbia University, New York City, NY, USA
| | - Yali Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China.
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Nealon J, Derqui N, de Courville C, Biering-Sørensen T, Cowling BJ, Nair H, Chaves SS. Looking back on 50 years of literature to understand the potential impact of influenza on extrapulmonary medical outcomes. Open Forum Infect Dis 2022; 9:ofac352. [PMID: 35937650 PMCID: PMC9350618 DOI: 10.1093/ofid/ofac352] [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] [Received: 06/09/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
We conducted a scoping review of the epidemiological literature from the past 50 years to document the contribution of influenza virus infection to extrapulmonary clinical outcomes. We identified 99 publications reporting 243 associations using many study designs, exposure and outcome definitions, and methods. Laboratory confirmation of influenza was used in only 28 (12%) estimates, mostly in case-control and self-controlled case series study designs. We identified 50 individual clinical conditions associated with influenza. The most numerous estimates were of cardiocirculatory diseases, neurological/neuromuscular diseases, and fetal/newborn disorders, with myocardial infarction the most common individual outcome. Due to heterogeneity, we could not generate summary estimates of effect size, but of 130 relative effect estimates, 105 (81%) indicated an elevated risk of extrapulmonary outcome with influenza exposure. The literature is indicative of systemic complications of influenza virus infection, the requirement for more effective influenza control, and a need for robust confirmatory studies.
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Affiliation(s)
- Joshua Nealon
- Sanofi , Lyon , France
- School of Public Health, The University of Hong Kong , Hong Kong Special Administrative Region , China
| | - Nieves Derqui
- Sanofi , Lyon , France
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London , UK
| | | | - Tor Biering-Sørensen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte , Copenhagen , Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Benjamin J Cowling
- School of Public Health, The University of Hong Kong , Hong Kong Special Administrative Region , China
| | - Harish Nair
- Usher Institute, The University of Edinburgh , Scotland , UK
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Papi A, Virchow JC, Singh D, Kots M, Vele A, Georges G, Canonica GW. Extrafine triple therapy and asthma exacerbation seasonality: TRIMARAN and TRIGGER post hoc analyses. J Allergy Clin Immunol 2021; 148:262-265.e2. [PMID: 33485959 DOI: 10.1016/j.jaci.2021.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/10/2020] [Accepted: 01/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Previous studies have shown seasonal variation in asthma exacerbations, peaking over the winter months. A single-inhaler triple therapy containing extrafine formulations of the inhaled corticosteroid (ICS) beclomethasone dipropionate (BDP), long-acting β2-agonist formoterol fumarate (FF), and long-acting muscarinic antagonist glycopyrronium (G) is in development for asthma. OBJECTIVE We sought to evaluate whether calendar season impacted the relative effect of BDP/FF/G versus BDP/FF on moderate and severe asthma exacerbations. METHODS TRIMARAN and TRIGGER were double-blind 52-week studies comparing BDP/FF/G with BDP/FF (TRIMARAN medium-dose ICS; TRIGGER high-dose) in adults with uncontrolled asthma (Asthma Control Questionnaire-7 score ≥1.5), prebronchodilator FEV1 less than 80% predicted, history of 1 or more asthma exacerbation, who had been receiving ICS/long-acting β2-agonist for at least 4 weeks before entry. Moderate and severe asthma exacerbations were captured throughout each study. In these post hoc analyses, the annual moderate and severe exacerbation rate was calculated for each month, with rate ratios determined from events grouped by season. RESULTS In patients who received BDP/FF alone, there was a marked seasonal effect on the occurrence of asthma exacerbations, with the rate highest in the winter months. However, the addition of the long-acting muscarinic antagonist component to BDP/FF reduced this seasonal variation, especially during the winter, such that the relative effect of BDP/FF/G versus BDP/FF was greatest in the winter (significant 20.3% reduction [P = .0008]). Reductions in the other seasons ranged between 8.6% and 12.0%. CONCLUSIONS These post hoc analyses indicate that inhaled triple therapy with extrafine BDP/FF/G reduces seasonal peaks in moderate and severe exacerbations, and confirm the overall utility of adding long-acting muscarinic antagonist to ICS/long-acting β2-agonist in the management of asthma.
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Affiliation(s)
- Alberto Papi
- Respiratory Medicine Unit, University of Ferrara, University Hospital S. Anna, Ferrara, Italy.
| | - Johann Christian Virchow
- Universitätsmedizin Rostock, Zentrum für Innere Medizin, Abteilung für Pneumologie, Rostock, Germany
| | - Dave Singh
- Medicines Evaluation Unit, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Maxim Kots
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy
| | - Andrea Vele
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy
| | - George Georges
- Global Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy
| | - Giorgio Walter Canonica
- Humanitas University and Research Hospital IRCCS, Center of Personalized Medicine: Asthma and Allergy, Milan, Italy
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Short-term effects of air pollution on exacerbations of allergic asthma in Užice region, Serbia. Postepy Dermatol Alergol 2020; 37:377-383. [PMID: 32792879 PMCID: PMC7394173 DOI: 10.5114/ada.2020.96254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/12/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Many time-series studies have shown a positive association between air pollution and asthma exacerbation. However, till now only one study in Serbia has examined this relationship. Aim To examine the associations between air pollution and asthma emergency department (ED) visits in the Užice region, Serbia. Material and methods A time-stratified case-crossover design was applied to 424 ED visits for asthma exacerbation that occurred in the Užice region, Serbia, in 2012–2014. Data about ED visits were routinely collected in the Užice Health Centre. The daily average concentrations of particulate matter (PM2.5 and PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and black carbon (BC) were measured by automatic ambient air quality monitoring stations. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity and air pressure). Results Statistically significant associations were observed between ED visits for asthma and 3-day lagged exposure to BC (OR = 3.23; 95% CI: 1.05–9.95), and between ED visits for asthma with coexisting allergic rhinitis and 0-day lag exposure to NO2 (OR = 1.57; 95% CI: 0.94–2.65), 2-day lag exposure to SO2 (OR = 1.97; 95% CI: 1.02–3.80), and 3-day lag exposure to PM10 (OR = 2.38; 95% CI: 1.17–4.84). Conclusions Exposure to ambient air pollution in the Užice region increases the risk of ED visits for asthma, particularly during the heating season.
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Shrestha SK, Lambert KA, Erbas B. Ambient pollen concentrations and asthma hospitalization in children and adolescents: a systematic review and meta-analysis. J Asthma 2020; 58:1155-1168. [PMID: 32419541 DOI: 10.1080/02770903.2020.1771726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ObjectiveWe aimed to conduct a systematic review examining the association between outdoor pollen and childhood asthma hospitalizations.Data SourceA systematic search of articles in MEDLINE, EMBASE, CINAHL, ProQuest Central, Web of Science and Google Scholar published to 18 July 2019.Study selection: Studies that presented data on pollen exposure and childhood asthma hospitalization were included and evaluated for potential risk of bias by two independent authors. Random effects meta-analysis was performed where possible.ResultsA total of 1048 records were identified, and twelve studies included in the review. The synthesis suggested possible associations between outdoor pollen, especially for grass and birch and childhood asthma hospitalization. However, the results varied widely across geographical areas and settings for other pollen taxa. The meta-analysis of the case-crossover studies showed a positive association between grass and childhood asthma hospitalization, an increase in 10 grass pollen grains/m3 was associated with a 3% increase in childhood asthma admission (OR = 1.03; 95%CI:1.01, 1.04), but the pooled estimate was not significant for timeseries studies. The meta-analysis of the timeseries studies for birch pollen showed an increase in 10 pollen grains/m3 being significantly associated with a Mean Percentage Change (MPC) in childhood asthma admissions (MPC= 0.85; 95%CI:0.40, 1.30).Conclusion: Globally, grass and birch pollen are important triggers of childhood asthma hospitalization, but the association could not be ascertained for other pollen taxa. Pollen is a major environmental trigger of asthma exacerbations and more focus on early interventions to reduce this burden needs to be considered.
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Affiliation(s)
- Som Kumar Shrestha
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Katrina Anne Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Olds JL, Kabbani N. Is nicotine exposure linked to cardiopulmonary vulnerability to COVID-19 in the general population? FEBS J 2020; 287:3651-3655. [PMID: 32189428 PMCID: PMC7228237 DOI: 10.1111/febs.15303] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 02/28/2020] [Accepted: 03/18/2020] [Indexed: 01/20/2023]
Abstract
The recent emergence of COVID‐19 has resulted in a worldwide crisis, with large populations locked down and transportation links severed. While approximately 80% of infected individuals have minimal symptoms, around 15–20% need to be hospitalized, greatly stressing global healthcare systems. As of March 10, the death rate appears to be about 3.4%, although this number is highly stratified among different populations. Here, we focus on those individuals who have been exposed to nicotine prior to their exposure to the virus. We predict that these individuals are ‘primed’ to be at higher risk because nicotine can directly impact the putative receptor for the virus (ACE2) and lead to deleterious signaling in lung epithelial cells.
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Affiliation(s)
- James L Olds
- SCHAR School of Public Policy, George Mason University, Arlington, VA, USA
| | - Nadine Kabbani
- School of Systems Biology, George Mason University, Fairfax, VA, USA
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Kuo CY, Chan CK, Wu CY, Phan DV, Chan CL. The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020203. [PMID: 30642061 PMCID: PMC6351918 DOI: 10.3390/ijerph16020203] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
- Department of Biotechnology, Ming Chuan University, 5 De Ming Road, Gui Shan Dist., Taoyuan 333, Taiwan.
| | - Chiung-Yi Wu
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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Caini S, Schellevis F, El-Guerche Séblain C, Paget J. Important changes in the timing of influenza epidemics in the WHO European Region over the past 20 years: virological surveillance 1996 to 2016. ACTA ACUST UNITED AC 2019; 23. [PMID: 29317016 PMCID: PMC5765775 DOI: 10.2807/1560-7917.es.2018.23.1.17-00302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The global epidemiology of many infectious diseases is changing, but little attention has been paid to whether the timing of seasonal influenza epidemics changed in recent years. This study investigated whether the timing of the peak of influenza epidemics has changed in countries of the World Health Organization (WHO) European Region between 1996 and 2016.
Methods: Surveillance data were obtained from the WHO FluNet database. For each country and season (July to June of the next year), the peak was defined as the week with the highest 3-week moving average for reported cases. Linear regression models were used to test for temporal trends in the timing of the epidemic peak in each country and to determine whether this differed geographically.
Results: More than 600,000 influenza cases were included from 38 countries of the WHO European Region. The timing of the epidemic peak changed according to a longitudinal gradient, occurring progressively later in Western Europe (e.g. by 2.8 days/season in Spain) and progressively earlier in Eastern Europe (e.g. by 3.5 days/season in the Russian Federation).
Discussion: These results were confirmed in several sensitivity analyses. Our findings have implications for influenza control and prevention measures in the WHO European Region, for instance for the implementation of influenza vaccination campaigns.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - François Schellevis
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Co-occurrence of Asthma and the Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis. Clin Transl Gastroenterol 2018; 9:188. [PMID: 30250122 PMCID: PMC6155154 DOI: 10.1038/s41424-018-0054-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/11/2018] [Indexed: 02/07/2023] Open
Abstract
Background Inflammatory bowel diseases (IBD) and asthma share genetic and environmental risk factors. Consequently, several observational studies have explored an association between IBD and asthma. We systematically reviewed and summarized the literature on the co-occurrence of asthma and IBD. Methods MEDLINE and EMBASE (to April 2017) were searched to identify observational studies on the association between asthma and IBD. Relative risks (RR) were pooled using random effects models. Heterogeneity was assessed using the I2 and Cochran Q statistics. Meta-regression based on study design, source of patients (population-based vs. tertiary-care center) and study location was conducted to explain between-study heterogeneity. Results Eighteen studies were identified (15 Crohn’s disease, 15 ulcerative colitis (UC)). Asthma was associated with both Crohn’s disease (pooled RR 1.30, 95% confidence interval (CI) 1.16–1.47, I2 = 88%) and UC (RR 1.34, 95% CI 1.24–1.44, I2 = 93%). The study design and source of patients and study location explained between-study heterogeneity in Crohn’s disease, but not UC. Conclusion Asthma is associated with both Crohn’s disease and UC. Additional research is needed to determine if one disease influences the risk of developing the other or if the frequent co-occurrence of these diseases result from shared genetic, environmental, and microbial risk factors.
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Martínez-Rivera C, Garcia-Olivé I, Stojanovic Z, Radua J, Ruiz Manzano J, Abad-Capa J. Association between air pollution and asthma exacerbations in Badalona, Barcelona (Spain), 2008-2016. Med Clin (Barc) 2018; 152:333-338. [PMID: 30149947 DOI: 10.1016/j.medcli.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Air pollution has been widely associated with respiratory diseases. Nevertheless, association between air pollution and exacerbations of asthma in our area has been less studied. To analyse the effect of air pollution on exacerbations of asthma in Badalona. MATERIAL AND METHODS This was an observational study conducted in Badalona. The number of daily hospital admissions and accident and emergency visits related to exacerbation of asthma between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, atmospheric pressure, relative humidity, and NO2, SO2 and CO levels on asthma-related emergencies and hospitalisations the same day and 1-4 days after. All p-values were corrected for multiple comparisons. RESULTS The number of hospitalisations was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 0, 1, 2 and 4) and atmospheric pressure (lags 2 and 3). The number of accident and emergency visits was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 2, 3 and 4). CONCLUSIONS The number of accident and emergency visits and hospitalisations for exacerbation of asthma is associated with higher levels of NO2 and with lower temperatures.
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Affiliation(s)
- Carlos Martínez-Rivera
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Ignasi Garcia-Olivé
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España.
| | - Zoran Stojanovic
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Joaquim Radua
- Department of Statistics, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, España; Ciber de Salud Mental (CiberSam), Madrid, España; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Estocolmo, Suecia; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Juan Ruiz Manzano
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Jorge Abad-Capa
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
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de Sousa TCM, Amancio F, Hacon SDS, Barcellos C. [Climate-sensitive diseases in Brazil and the world: systematic reviewEnfermedades sensibles al clima en Brasil y el mundo: revisión sistemática]. Rev Panam Salud Publica 2018; 42:e85. [PMID: 31093113 PMCID: PMC6385874 DOI: 10.26633/rpsp.2018.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To survey the literature regarding climate-sensitive diseases (CSD) and the impacts of climate changes on health. METHOD This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Lilacs, SciELO, Scopus, and PubMed databases were searched in July 2017 without temporal restrictions for articles published in in Portuguese, English and Spanish. The following search strategy was used in all databases: (climate) AND (disease) AND (sensitive). RESULTS The systematic review included 106 articles, most of which focused on dengue, malaria, and respiratory and cardiovascular diseases. The most commonly studied climate variables were temperature and precipitation. The studies revealed a relationship between the incidence of certain diseases, especially cardiovascular and respiratory diseases, dengue, malaria, and arboviral diseases, and climate conditions in different regions of the world. This relationship was analyzed considering both past data on the incidence of diseases and climate variables and projections regarding the future incidence of diseases according to expected climate variations. A greater number of studies was performed by authors originating from developed countries. The world regions most often studied were China, the United States, Australia, and Brazil. CONCLUSIONS Despite the increase in the number of published articles on this theme, a greater number of climate and environmental variables must be studied, with expansion of studies to additional regions in the world.
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Affiliation(s)
| | - Flavia Amancio
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Sandra de Sousa Hacon
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Christovam Barcellos
- Fundação Oswaldo Cruz (Fiocruz), Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Rio de Janeiro (RJ), Brasil
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14
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Shrestha P, Poudel DR, Dhital R, Karmacharya P. Seasonal and regional variation of asthma-related hospitalizations and mortality among adults in the United States. Ann Allergy Asthma Immunol 2018; 121:368-369. [PMID: 29981441 DOI: 10.1016/j.anai.2018.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/22/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Pragya Shrestha
- Department of Medicine Reading Hospital-Tower Health System West Reading, Pennsylvania.
| | - Dilli R Poudel
- Department of Medicine Reading Hospital-Tower Health System West Reading, Pennsylvania
| | - Rashmi Dhital
- Department of Medicine Reading Hospital-Tower Health System West Reading, Pennsylvania
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15
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Kuo CY, Pan RH, Chan CK, Wu CY, Phan DV, Chan CL. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040647. [PMID: 29614737 PMCID: PMC5923689 DOI: 10.3390/ijerph15040647] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/16/2022]
Abstract
Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O₃, SO₂, and NO₂) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O₃ in spring in Taipei. In children aged 0-6 years, asthma was associated with O₃ in Taipei and SO₂ in Kaohsiung, after controlling for the daily mean temperature and relative humidity.
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Affiliation(s)
- Ching-Yen Kuo
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Ren-Hao Pan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chiung-Yi Wu
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, , 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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16
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Lee JH, Lee HY, Jung CG, Ban GY, Shin YS, Ye YM, Nahm DH, Park HS. Therapeutic Effect of Omalizumab in Severe Asthma: A Real-World Study in Korea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:121-130. [PMID: 29411552 PMCID: PMC5809760 DOI: 10.4168/aair.2018.10.2.121] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/30/2017] [Accepted: 11/14/2017] [Indexed: 12/11/2022]
Abstract
Purpose Omalizumab, an anti-immunoglobulin E (IgE) monoclonal antibody, has proved to be effective for the treatment of severe asthma. However, there is no direct evidence of effectiveness of omalizumab in Korean patients with severe asthma. We sought to evaluate the real-world effectiveness of omalizumab in Korean adult patients suffering from severe asthma and to identify predictors of favorable response. Methods A retrospective analysis of electrical medical records was performed on severe allergic asthmatic patients with omalizumab treatment group (OT group) for more than 6 months between March 2008 and February 2016. Propensity score matching was applied to define the standardized treatment control group (STC group) treated without omalizumab. Asthma-related outcomes were compared between the 2 groups, and analyzed before and after omalizumab use in the OT group. Responders to treatment were defined as patients showing >50% reduction in asthma exacerbations and/or systemic steroid requirement during the outcome period. Results One hundred twenty-four patients with severe asthma (62 in the OT group; 62 in the STC group) were enrolled in the study. Proportion of patients having the reduction of asthma exacerbation (53.2% vs 35.5%, P=0.015) and the rate of responders (67.7% vs 41.9%, P=0.007) were significantly higher in the OT group than in the STC group. Significant reductions were noted in asthma exacerbation (P=0.006), hospitalization (P=0.009), hospitalization days (P=0.006), systemic corticosteroid requirements (P=0.027), and sputum eosinophil count (P=0.031) in OT group compared with STC group. There were no significant differences in changes of forced expiratory volume in the 1 second (FEV1) levels between the 2 groups. No predictors of responders were found for omalizumab treatment. Conclusions Omalizumab can reduce exacerbations/hospitalization/systemic steroid burst in Korean adult patients with severe asthma.
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Affiliation(s)
- Ji Ho Lee
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Young Lee
- Department of Statistics, Clinical Trial Center, Ajou University Medical Center, Suwon, Korea
| | - Chang Gyu Jung
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Ga Young Ban
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Yoo Seob Shin
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Dong Ho Nahm
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hae Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
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17
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Osborne NJ, Alcock I, Wheeler BW, Hajat S, Sarran C, Clewlow Y, McInnes RN, Hemming D, White M, Vardoulakis S, Fleming LE. Pollen exposure and hospitalization due to asthma exacerbations: daily time series in a European city. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1837-1848. [PMID: 28500390 PMCID: PMC5643363 DOI: 10.1007/s00484-017-1369-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/17/2017] [Accepted: 04/27/2017] [Indexed: 05/03/2023]
Abstract
Exposure to pollen can contribute to increased hospital admissions for asthma exacerbation. This study applied an ecological time series analysis to examine associations between atmospheric concentrations of different pollen types and the risk of hospitalization for asthma in London from 2005 to 2011. The analysis examined short-term associations between daily pollen counts and hospital admissions in the presence of seasonal and long-term patterns, and allowed for time lags between exposure and admission. Models were adjusted for temperature, precipitation, humidity, day of week, and air pollutants. Analyses revealed an association between daily counts (continuous) of grass pollen and adult hospital admissions for asthma in London, with a 4-5-day lag. When grass pollen concentrations were categorized into Met Office pollen 'alert' levels, 'very high' days (vs. 'low') were associated with increased admissions 2-5 days later, peaking at an incidence rate ratio of 1.46 (95%, CI 1.20-1.78) at 3 days. Increased admissions were also associated with 'high' versus 'low' pollen days at a 3-day lag. Results from tree pollen models were inconclusive and likely to have been affected by the shorter pollen seasons and consequent limited number of observation days with higher tree pollen concentrations. Future reductions in asthma hospitalizations may be achieved by better understanding of environmental risks, informing improved alert systems and supporting patients to take preventive measures.
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Affiliation(s)
- Nicholas J Osborne
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK.
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Ian Alcock
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Shakoor Hajat
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Rachel N McInnes
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
- Met Office Hadley Centre, Fitzroy Road, Exeter, EX1 3PB, UK
| | | | - Mathew White
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Sotiris Vardoulakis
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon, OX11 0RQ, UK
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
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18
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Cabana MD. Corticosteroids and Asthma: Too Much or Too Little? Pediatrics 2017; 139:peds.2017-0598. [PMID: 28557773 DOI: 10.1542/peds.2017-0598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Michael D Cabana
- Departments of Pediatrics and Epidemiology and Biostatistics, and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
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19
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Casas L, Simons K, Nawrot TS, Brasseur O, Declerck P, Buyl R, Coomans D, Nemery B, Van Nieuwenhuyse A. Respiratory medication sales and urban air pollution in Brussels (2005 to 2011). ENVIRONMENT INTERNATIONAL 2016; 94:576-582. [PMID: 27346740 DOI: 10.1016/j.envint.2016.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/26/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND We investigated the associations between daily sales of respiratory medication and air pollutants in the Brussels-Capital Region between 2005 and 2011. METHODS We used over-dispersed Poisson Generalized Linear Models to regress daily individual reimbursement data of prescribed asthma and COPD medication from the social security database against each subject's residential exposure to outdoor particulate matter (PM10) or NO2 estimated, by interpolation from monitoring stations. We calculated cumulative risk ratios (RR) and their 95% confidence intervals (CI) for interquartile ranges (IQR) of exposure for different windows of past exposure for the entire population and for seven age groups. RESULTS Median daily concentrations of PM10 and NO2 were 25μg/m(3) (IQR=17.1) and 38μg/m(3) (IQR=20.5), respectively. PM10 was associated with daily medication sales among individuals aged 13 to 64y. For NO2, significant associations were observed among all age groups except >84y. The highest RR were observed for NO2, among adolescents, including three weeks lags (RR=1.187 95%CI: 1.097-1.285). CONCLUSION The associations found between temporal changes in exposure to air pollutants and daily sales of respiratory medication in Brussels indicate that urban air pollution contributes to asthma and COPD morbidity in the general population.
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Affiliation(s)
- Lidia Casas
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003 Barcelona, Spain
| | - Koen Simons
- Unit Health and Environment, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; Department of Biostatistics and Medical Informatics, Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Olivier Brasseur
- Department Laboratory and Air Quality, Brussels Environment, Gulledelle 100, 1200 Brussels, Belgium
| | - Priscilla Declerck
- Department Laboratory and Air Quality, Brussels Environment, Gulledelle 100, 1200 Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Danny Coomans
- Department of Biostatistics and Medical Informatics, Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - An Van Nieuwenhuyse
- Unit Health and Environment, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
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20
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[Seasonality in asthma: Impact and treatments]. Presse Med 2016; 45:1005-1018. [PMID: 27039335 DOI: 10.1016/j.lpm.2016.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/18/2016] [Accepted: 01/25/2016] [Indexed: 12/12/2022] Open
Abstract
The role of seasons should be taken into account in the management of asthma. The environment varies between seasons and it is well documented that asthma is modulated by environment. Viruses cause asthma exacerbations peak, in winter, in adults while the peak is present in September in children. Allergens are probably a less powerful source of asthma exacerbation than viruses but pollen involvement in spring and summer and dust mites in autumn are indisputable. Air pollutants, present in summer during the hottest periods, are also highly involved in asthma exacerbations. Indoor air pollution, in winter, is also implicated in asthma disease. All these environmental factors are synergistic and increase the risk of asthma exacerbation. Therapies should be adapted to each season depending on environmental factors potentially involved in the asthma disease.
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21
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Sun X, Waller A, Yeatts KB, Thie L. Pollen concentration and asthma exacerbations in Wake County, North Carolina, 2006-2012. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 544:185-91. [PMID: 26657364 DOI: 10.1016/j.scitotenv.2015.11.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/23/2015] [Accepted: 11/20/2015] [Indexed: 05/27/2023]
Abstract
Pollen has been generally linked to an increased risk for asthma exacerbation. However, the delayed effect (lag), the length of effect duration, and the association heterogeneity by pollen types have not been well characterized. Short-term associations between ambient concentration of various pollen types (tree, grass, and weed) and emergency department (ED) visits for asthma were assessed using data in Wake County, North Carolina, during 2006-2012. Distributed lag nonlinear models (DLNM) were used to characterize the associations, while adjusting for air pollutants, meteorological, and temporal factors. A strong association between same-day tree pollen and asthma ED visits was detected. This association lasted four days, with a 4-day cumulative risk ratio (RR) up to 2.10 (3500 grains/m(3) vs. 0 grains/m(3), 95% confidence interval [CI]=1.21-3.65). The associations of asthma ED visits with weed pollen and grass pollen were weak, suggestively starting from lag 2 and lasting 3 days, with the strongest association a 3-day cumulative RR of 1.08 (32 grains/m(3) vs. 0 grains/m(3), 95% CI=1.01-1.15) and 1.05 (11 grains/m(3) vs. 0 grains/m(3), 95% CI=1.00-1.11). Our results indicate that the association of ambient pollen and asthma exacerbation vary by pollen type, both quantitatively and temporally. These findings have important implications for optimizing targeted allergic disease prevention and management, and helping understand the etiology of ambient exposure-induced allergic diseases.
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Affiliation(s)
- Xuezheng Sun
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Anna Waller
- Carolina Center for Health Informatics, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, United States
| | - Karin B Yeatts
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Lauren Thie
- North Carolina Department of Health and Human Services, Raleigh, NC 27699, United States.
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22
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Inoue K, Takano H. Epidemiology of asthma exacerbations and their relation with environmental factors in the Basque Country. Clin Exp Allergy 2016; 45:1475. [PMID: 26112827 DOI: 10.1111/cea.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K Inoue
- School of Nursing, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan
| | - H Takano
- Graduate School of Engineering, Kyoto University, Kyoto, Japan
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23
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Brzezińska-Pawłowska OE, Rydzewska AD, Łuczyńska M, Majkowska-Wojciechowska B, Kowalski ML, Makowska JS. Environmental factors affecting seasonality of ambulance emergency service visits for exacerbations of asthma and COPD. J Asthma 2015; 53:139-45. [PMID: 26369434 DOI: 10.3109/02770903.2015.1075547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to assess the association of severe exacerbations of asthma and Chronic Obstructive Pulmonary Disease (COPD) requiring ambulance emergency service (AES) visits with meteorological parameters and influenza outbreaks. METHODS The records of patients calling the AES in 2007 and 2008 in the urban area of Lodz due to dyspnea were analyzed. Information on 25 daily reported meteorological parameters was obtained from the local meteorological service and data on influenza outbreaks obtained from the national surveillance service. RESULTS During the winter months, a significantly higher mean daily number of AES visits for both COPD and asthma were noticed when compared to the summer. Interestingly, the number of daily AES visits correlated with several weather parameters, and the multiple regression analysis confirmed a negative correlation with minimum temperature, mean temperature and the dew point for both diseases (R = 0.526; p < 0.01; R = 0.577; p < 0.01 and R = 0.589; p < 0.01). Furthermore, the increased number of AES visits also correlated with a new number of cases of influenza infections as reported by local influenza surveillance system (rs = 77.6%; p < 0.001 and rs = 80.8%; p < 0.001 for asthma and COPD, respectively). CONCLUSION Seasonality of AES visits for asthma and COPD are similar and seems to be related to specific weather conditions and to influenza outbreaks.
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Affiliation(s)
- Olga E Brzezińska-Pawłowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Anna D Rydzewska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marta Łuczyńska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Barbara Majkowska-Wojciechowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marek L Kowalski
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Joanna S Makowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
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