Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: Age-stratified time-series analysis
- Authors
- Lee, Seung Won; Yon, Dong Keon; James, Chase C.; Lee, Shinhae; Koh, Hyun Yong; Sheen, Youn Ho; Oh, Jae-Won; Han, Man Yong; Sugihara, George
- Issue Date
- Dec-2019
- Publisher
- MOSBY-ELSEVIER
- Keywords
- Asthma exacerbation; air pollutant; weather condition; aeroallergen; human rhinovirus; influenza virus
- Citation
- JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, v.144, no.6, pp.1542 - 1550.e1
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
- Volume
- 144
- Number
- 6
- Start Page
- 1542
- End Page
- 1550.e1
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/146655
- DOI
- 10.1016/j.jaci.2019.08.037
- ISSN
- 0091-6749
- 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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