2017-2019 年墨西哥城空气质量与哮喘相关急诊入院率之间的关系
2023/11/23
摘要
背景：先前的研究发现，暴露于空气污染物会导致儿童和成人哮喘患者的哮喘急性发作，并增加与哮喘相关的急诊入院率（AREHA）。
方法：从墨西哥城获取了2017年至2019年的AREHA和空气污染物（PM10，PM2.5和NO2）水平。采用时间序列方法探讨了空气污染物与AREHA之间的关系。在幼儿（小于5岁）和成人（大于18岁）中，使用负二项式回归估计AREHA的相对风险。
结果：在成人中，AREHA与PM10，PM2.5和NO2呈正相关，即使在这些污染物相互调整后仍然存在。成人入院的相对风险（RR）随PM10每立方米增加10微克，增加3％（95％CI为1％至4％），随PM2.5每立方米增加5微克，增加1％（0.03％至3％），随NO2每立方米增加5微克，增加1％（0.06％至2％）。相反，在幼儿中，AREHA与PM10呈负相关，调整NO2后（每立方米增加10微克，RR为0.97（0.95至0.99）），与NO2在调整PM10和PM2.5后（每立方米增加5微克，分别为RR 0.98（0.96至0.99）和0.97（0.96至0.99））呈负相关。在调整NO2后，儿童的AREHA与PM2.5无关。
结论：在墨西哥城，前一周的环境空气污染与成年人因哮喘而被公立医院急诊收治有关。儿童的关系则不太一致。还需要进一步研究成人和儿童之间存在差异的原因，以便采取适当的干预措施，促进公众健康。
Relationship between air quality and asthma-related emergency hospital admissions in Mexico City 2017-2019
Hayes L, Mejia-Arangure JM, Errington A, Bramwell L, Vega E, Nunez-Enriquez JC, Namdeo A, Entwistle J, Miquelajauregui Y, Jaimes-Palomera M, Torres N, Rascón-Pacheco RA, Duarte-Rodríguez DA, McNally R.
Abstract
Background:Previous studies found exposure to air pollution leads to exacerbations of asthma in paediatric and adult patients and increases asthma-related emergency hospital admissions (AREHA).
Methods:AREHAs and levels of air pollutants (PM10, PM2.5 and NO2) were obtained from Mexico City for the period 2017-2019. A time-series approach was used to explore the relationship between air pollutants and AREHA. Relative risks of AREHA were estimated using a negative binomial regression in young children (less than 5 years) and adults (greater than 18 years).
Results:There was a positive association between AREHA and PM10, PM2.5 and NO2 in adults, which remained after mutual adjustment for these pollutants. The relative risk (RR) of admission in adults increased by 3% (95% CI 1% to 4%) for a 10 µg/m3 increase in PM10, 1% (0.03% to 3%) for a 5 µg/m3 increase in PM2.5 and by 1% (0.06% to 2%) for a 5 µg/m3 increase in NO2. In contrast, in young children, AREHAs were negatively associated with PM10 after adjustment for NO2 (RR 0.97 (0.95 to 0.99) for a 10 µg/m3 and with NO2 after adjustment for PM10 and PM2.5 (RR 0.98 (0.96 to 0.99) and 0.97 (0.96 to 0.99), respectively, for a 5 µg/m3 increase in NO2). AREHAs in children were not associated with PM2.5 after adjustment for NO2.
Conclusion:Ambient air pollution, within the previous week, was associated with emergency hospital admissions for asthma to public hospitals in adults in Mexico City. The relationship in children was less consistent. Further work is needed to explore why differences between adults and children exist to inform appropriate interventions to benefit public health.
背景：先前的研究发现，暴露于空气污染物会导致儿童和成人哮喘患者的哮喘急性发作，并增加与哮喘相关的急诊入院率（AREHA）。
方法：从墨西哥城获取了2017年至2019年的AREHA和空气污染物（PM10，PM2.5和NO2）水平。采用时间序列方法探讨了空气污染物与AREHA之间的关系。在幼儿（小于5岁）和成人（大于18岁）中，使用负二项式回归估计AREHA的相对风险。
结果：在成人中，AREHA与PM10，PM2.5和NO2呈正相关，即使在这些污染物相互调整后仍然存在。成人入院的相对风险（RR）随PM10每立方米增加10微克，增加3％（95％CI为1％至4％），随PM2.5每立方米增加5微克，增加1％（0.03％至3％），随NO2每立方米增加5微克，增加1％（0.06％至2％）。相反，在幼儿中，AREHA与PM10呈负相关，调整NO2后（每立方米增加10微克，RR为0.97（0.95至0.99）），与NO2在调整PM10和PM2.5后（每立方米增加5微克，分别为RR 0.98（0.96至0.99）和0.97（0.96至0.99））呈负相关。在调整NO2后，儿童的AREHA与PM2.5无关。
结论：在墨西哥城，前一周的环境空气污染与成年人因哮喘而被公立医院急诊收治有关。儿童的关系则不太一致。还需要进一步研究成人和儿童之间存在差异的原因，以便采取适当的干预措施，促进公众健康。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Thorax. 2023 Nov 8; DOI: 10.1136/thorax-2022-219262)
(Thorax. 2023 Nov 8; DOI: 10.1136/thorax-2022-219262)
Relationship between air quality and asthma-related emergency hospital admissions in Mexico City 2017-2019
Hayes L, Mejia-Arangure JM, Errington A, Bramwell L, Vega E, Nunez-Enriquez JC, Namdeo A, Entwistle J, Miquelajauregui Y, Jaimes-Palomera M, Torres N, Rascón-Pacheco RA, Duarte-Rodríguez DA, McNally R.
Abstract
Background:Previous studies found exposure to air pollution leads to exacerbations of asthma in paediatric and adult patients and increases asthma-related emergency hospital admissions (AREHA).
Methods:AREHAs and levels of air pollutants (PM10, PM2.5 and NO2) were obtained from Mexico City for the period 2017-2019. A time-series approach was used to explore the relationship between air pollutants and AREHA. Relative risks of AREHA were estimated using a negative binomial regression in young children (less than 5 years) and adults (greater than 18 years).
Results:There was a positive association between AREHA and PM10, PM2.5 and NO2 in adults, which remained after mutual adjustment for these pollutants. The relative risk (RR) of admission in adults increased by 3% (95% CI 1% to 4%) for a 10 µg/m3 increase in PM10, 1% (0.03% to 3%) for a 5 µg/m3 increase in PM2.5 and by 1% (0.06% to 2%) for a 5 µg/m3 increase in NO2. In contrast, in young children, AREHAs were negatively associated with PM10 after adjustment for NO2 (RR 0.97 (0.95 to 0.99) for a 10 µg/m3 and with NO2 after adjustment for PM10 and PM2.5 (RR 0.98 (0.96 to 0.99) and 0.97 (0.96 to 0.99), respectively, for a 5 µg/m3 increase in NO2). AREHAs in children were not associated with PM2.5 after adjustment for NO2.
Conclusion:Ambient air pollution, within the previous week, was associated with emergency hospital admissions for asthma to public hospitals in adults in Mexico City. The relationship in children was less consistent. Further work is needed to explore why differences between adults and children exist to inform appropriate interventions to benefit public health.
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支气管哮喘与冠心病：一项观察性孟德尔随机研究
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孕期母亲焦虑与学龄前儿童哮喘的关系：马鞍山出生队列研究
