■全球已发生26起流行性雷暴哮喘(ETSA)事件,墨尔本是ETSA的中心,有7个记录事件,2016年经历了有史以来最致命的ETSA事件。卫生服务和急诊科不堪重负,成千上万的人需要为急性哮喘提供医疗服务,有10人死亡。
■这项多学科研究是在各个卫生和科学部门进行的,目的是提高我们对ETSA背后机制的集体理解。
■这项研究涉及对花粉和真菌孢子的大气采样进行时间分辨分析,与不同天气参数相比,完整和破裂的花粉,污染水平和临床哮喘表现。
■DeakinAirWATCHBurwood收集的时间分辨花粉和真菌孢子数据,进行了3小时分析,为了更好地反映“之前”,\'在\'和\'ETSA时间点之后,在墨尔本2016年活动之前和之后的日子里。与维多利亚州环境保护局(EPA)提供的大气污染数据进行了线性相关,来自气象局(BOM)的天气数据和来自卫生部维多利亚州卫生信息局(VAHI)的临床哮喘报告数据。
■当雷暴流到达伯伍德时,草花粉粒破裂的计数增加了250%。PM10增加,相对湿度高,在风暴流出中观察到的温度下降和臭氧浓度低与草花粉破裂水平升高有关。特别是,在本次ETSA事件前6小时观察到的高臭氧水平可能是即将发生的ETSA事件的关键早期指标,由于高臭氧水平与增加花粉过敏原含量和降低花粉完整性有关,这反过来可能有助于增加花粉破裂。
■本文中提出的发现强调了包括破裂的花粉和时间分辨分析以预测ETSA事件从而挽救生命的重要性。
There have been 26 epidemic thunderstorm asthma (ETSA) events worldwide, with Melbourne at the epicentre of ETSA with 7 recorded events, and in 2016 experienced the deadliest ETSA event ever recorded. Health services and emergency departments were overwhelmed with thousands requiring medical care for acute asthma and 10 people died.
This multidisciplinary study was conducted across various health and science departments with the aim of improving our collective understanding of the mechanism behind ETSA.
This study involved time-resolved analysis of atmospheric sampling of the air for pollen and fungal spores, and intact and ruptured pollen compared with different weather parameters, pollution levels and clinical asthma presentations.
Time-resolved pollen and fungal spore data collected by Deakin AirWATCH Burwood, underwent 3-h analysis, to better reflect the \'before\', \'during\' and \'after\' ETSA time points, on the days leading up to and following the Melbourne 2016 event. Linear correlations were conducted with atmospheric pollution data provided by the Environment Protection Authority (EPA) of Victoria, weather data sourced from Bureau of Meteorology (BOM) and clinical asthma presentation data from the Victorian Agency for Health Information (VAHI) of Department of Health.
Counts of ruptured grass pollen grains increased 250% when the thunderstorm outflow reached Burwood. Increased PM10, high relative humidity, decreased temperature and low ozone concentrations observed in the storm outflow were correlated with increased levels of ruptured grass pollen. In particular, high ozone levels observed 6 h prior to this ETSA event may be a critical early indicator of impending ETSA event, since high ozone levels have been linked to increasing pollen allergen content and reducing pollen integrity, which may in turn contribute to enhanced pollen rupture.
The findings presented in this article highlight the importance of including ruptured pollen and time-resolved analysis to forecast ETSA events and thus save lives.