PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■有越来越多的证据将短期环境二氧化氮（NO2）暴露与儿童哮喘相关的住院联系起来。然而,大多数研究依赖于时间分辨的暴露信息，可能忽略了NO2的空间变异性。我们旨在调查来自高度分辨的时空模型的每日NO2估计值如何与英格兰儿童哮喘紧急入院的风险相关。
我们进行了一项时间分层的病例交叉研究，包括2011年1月1日至2015年12月31日在英格兰因哮喘儿童（0-14岁）急诊住院的111,766人。通过结合土地利用数据和化学运输模型估计，使用时空模型预测了患者居住地的每日NO2水平。使用条件逻辑回归模型来获得调整温度后的优势比（OR）和置信区间（CI），相对湿度,银行假日,和流感率。按年龄划分的效果修改，性别,季节,地区一级的收入剥夺，和区域进行了分层分析。
■对于NO2暴露量每增加10µg/m3，我们使用5天移动NO2平均值(平均滞后0-4)观察到哮喘相关急诊入院增加8%(OR1.08,95%CI1.06-1.10).在分层分析中，我们发现男性(OR1.10,95%CI1.07-1.12)和寒冷季节(OR1.10,95%CI1.08-1.12)的效应量较大.效果估计因年龄组而异，地区一级的收入剥夺，和区域。
■在英格兰儿童中，短期暴露于NO2与哮喘紧急入院风险增加显著相关。未来的指导和政策需要考虑反映某些经过验证的修改，例如使用针对季节的空气污染控制对策，保护高危人群。
我们进行了一项时间分层的病例交叉研究，包括2011年1月1日至2015年12月31日在英格兰因哮喘儿童（0-14岁）急诊住院的111,766人。通过结合土地利用数据和化学运输模型估计，使用时空模型预测了患者居住地的每日NO2水平。使用条件逻辑回归模型来获得调整温度后的优势比（OR）和置信区间（CI），相对湿度,银行假日,和流感率。按年龄划分的效果修改，性别,季节,地区一级的收入剥夺，和区域进行了分层分析。
■对于NO2暴露量每增加10µg/m3，我们使用5天移动NO2平均值(平均滞后0-4)观察到哮喘相关急诊入院增加8%(OR1.08,95%CI1.06-1.10).在分层分析中，我们发现男性(OR1.10,95%CI1.07-1.12)和寒冷季节(OR1.10,95%CI1.08-1.12)的效应量较大.效果估计因年龄组而异，地区一级的收入剥夺，和区域。
■在英格兰儿童中，短期暴露于NO2与哮喘紧急入院风险增加显著相关。未来的指导和政策需要考虑反映某些经过验证的修改，例如使用针对季节的空气污染控制对策，保护高危人群。
