OBJECTIVE: Are short-term increases in PM2.5 and ozone in wildfire season and in winter inversion season associated with a composite of emergency or inpatient hospitalization for asthma and COPD?
METHODS: Case-crossover analyses evaluated 63,976 and 18,514 patients hospitalized for primary discharge diagnoses of asthma and COPD, respectively, between January 1999 and March 2022. Patients resided on Utah\'s Wasatch Front where PM2.5 and ozone were measured by Environmental Protection Agency-based monitors. ORs were calculated using Poisson regression adjusted for weather variables.
RESULTS: Asthma risk increased on the same day that PM2.5 increased during wildfire season (OR, 1.057 per + 10 μg/m3; 95% CI, 1.019-1.097; P = .003) and winter inversions (OR, 1.023 per +10 μg/m3; 95% CI, 1.010-1.037; P = .0004). Risk decreased after 1 week, but during wildfire season risk rebounded at a 4-week lag (OR, 1.098 per +10 μg/m3; 95% CI, 1.033-1.167). Asthma risk for adults during wildfire season was highest in the first 3 days after PM2.5 increases, but for children, the highest risk was delayed by 3 to 4 weeks. PM2.5 exposure was weakly associated with COPD hospitalization. Ozone exposure was not associated with elevated risks.
CONCLUSIONS: In a large urban population, short-term increases in PM2.5 during wildfire season were associated with asthma hospitalization, and the effect sizes were greater than for PM2.5 during inversion season.
目的:野火季节和冬季倒置季节的PM2.5和臭氧的短期增加是否与哮喘和COPD的急诊或住院复合相关?
方法:病例交叉分析评估了因哮喘和COPD的初次出院诊断而住院的63,976和18,514名患者分别,1999年1月至2022年3月。患者居住在犹他州的Wasatch前线,由环境保护局的监测仪测量PM2.5和臭氧。使用针对天气变量调整后的泊松回归计算OR。
结果:在野火季节PM2.5增加的同一天,哮喘风险增加(或,每+10μg/m31.057;95%CI,1.019-1.097;P=.003)和冬季倒置(OR,每+10μg/m31.023;95%CI,1.010-1.037;P=.0004)。1周后风险降低,但在野火季节,风险在4周后反弹(或,每+10μg/m31.098;95%CI,1.033-1.167)。在PM2.5增加后的前3天,野火季节成年人的哮喘风险最高。但对孩子们来说,最高风险延迟3~4周.PM2.5暴露与COPD住院的相关性弱。臭氧暴露与风险升高无关。
结论:在庞大的城市人口中,在野火季节PM2.5的短期增加与哮喘住院有关,在倒转季节,效应大小大于PM2.5。