背景:哮喘加重是急诊就诊的一个重要原因,但对包括病毒和变应原花粉在内的环境触发因素的作用还不清楚。更好地了解病毒和花粉类型造成的暴露和风险的时空变化可以帮助优先考虑公共卫生干预措施。
目的:在这里,我们量化了区域重要的柏科花粉的影响,树花粉,其他花粉类型,鼻病毒,季节性冠状病毒,呼吸道合胞病毒,和流感对居住在德克萨斯州八个花粉监测站附近的人的哮喘相关急诊科就诊。
方法:我们使用年龄分层泊松回归分析来量化过敏性花粉和病毒对哮喘相关急诊就诊的影响。
结果:幼儿(<5岁)与哮喘相关的急诊发生率很高(24.1次/1,000,000人日),主要归因于病毒(51.2%)。学龄儿童的比率也很高(20.7次访问/1,000,000人日),归因于病毒(57.0%),柏科花粉(0.7%),和树木花粉(2.8%)。成人的比例较低(8.1次/1,000,000人日),这归因于病毒(25.4%),柏科花粉(0.8%),和树木花粉(2.3%)。这种风险在空间和时间上分布不均;例如,在樱桃科的高峰期,这种花粉占奥斯汀附近成人急诊科就诊的8.2%,这些植物很丰富,但是在像休斯顿这样的城市中,他们不是这样的城市为0.4%;其他年龄组的结果相似。
结论:尽管病毒是哮喘相关急诊就诊的主要原因,空气传播的花粉可以解释有意义的部分访问在高峰花粉季节,这种风险随时间和空间的变化,因为植物组成的差异。
BACKGROUND: Asthma exacerbations are an important cause of emergency department visits but much remains unknown about the role of environmental triggers including viruses and allergenic pollen. A better understanding of spatio-temporal variation in exposure and risk posed by viruses and pollen types could help prioritize public health interventions.
OBJECTIVE: Here we quantify the effects of regionally important Cupressaceae pollen, tree pollen, other pollen types, rhinovirus, seasonal coronavirus, respiratory syncytial virus, and influenza on asthma-related emergency department visits for people living near eight pollen monitoring stations in Texas.
METHODS: We used age stratified Poisson regression analyses to quantify the effects of allergenic pollen and viruses on asthma-related emergency department visits.
RESULTS: Young children (<5 years of age) had high asthma-related emergency department rates (24.1 visits/1,000,000 person-days), which were mainly attributed to viruses (51.2%). School-aged children also had high rates (20.7 visits/1,000,000 person-days), which were attributed to viruses (57.0%), Cupressaceae pollen (0.7%), and tree pollen (2.8%). Adults had lower rates (8.1 visits/1,000,000 person-days) which were attributed to viruses (25.4%), Cupressaceae pollen (0.8%), and tree pollen (2.3%). This risk was spread unevenly across space and time; for example, during peak Cuppressaceae season, this pollen accounted for 8.2% of adult emergency department visits near Austin where these plants are abundant, but 0.4% in cities like Houston where they are not; results for other age groups were similar.
CONCLUSIONS: Although viruses are a major contributor to asthma-related emergency department visits, airborne pollen can explain a meaningful portion of visits during peak pollen season and this risk varies over both time and space because of differences in plant composition.