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Jacobson JS, Goldstein A. Inge F. Goldstein, DrPH, Epidemiologist Who Identified Causes of Asthma's Unequal Toll on Urban Poor, Dies at 91. Am J Epidemiol 2024; 193:235-237. [PMID: 37727962 DOI: 10.1093/aje/kwad187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/27/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
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2
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Cochran SJ, Acosta L, Divjan A, Lemons AR, Rundle AG, Miller RL, Sobek E, Green BJ, Perzanowski MS, Dannemiller KC. Fungal diversity in homes and asthma morbidity among school-age children in New York City. ENVIRONMENTAL RESEARCH 2023; 239:117296. [PMID: 37806477 PMCID: PMC10842248 DOI: 10.1016/j.envres.2023.117296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Asthma development has been inversely associated with exposure to fungal diversity. However, the influence of fungi on measures of asthma morbidity is not well understood. OBJECTIVES This study aimed to test the hypothesis that fungal diversity is inversely associated with neighborhood asthma prevalence and identify specific fungal species associated with asthma morbidity. METHODS Children aged 7-8 years (n = 347) living in higher (11-18%) and lower (3-9%) asthma prevalence neighborhoods were recruited within an asthma case-control study. Fungal communities were analyzed from floor dust using high-throughput DNA sequencing. A subset of asthmatic children (n = 140) was followed to age 10-11 to determine asthma persistence. RESULTS Neighborhood asthma prevalence was inversely associated with fungal species richness (P = 0.010) and Shannon diversity (P = 0.059). Associations between neighborhood asthma prevalence and diversity indices were driven by differences in building type and presence of bedroom carpet. Among children with asthma at age 7-8 years, Shannon fungal diversity was inversely associated with frequent asthma symptoms at that age (OR 0.57, P = 0.025) and with asthma persistence to age 10-11 (OR 0.48, P = 0.043). Analyses of individual fungal species did not show significant associations with asthma outcomes when adjusted for false discovery rates. DISCUSSION Lower fungal diversity was associated with asthma symptoms in this urban setting. Individual fungal species associated with asthma morbidity were not detected. Further research is warranted into building type, carpeting, and other environmental characteristics which influence fungal exposures in homes.
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Affiliation(s)
- Samuel J Cochran
- Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Adnan Divjan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Angela R Lemons
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, 10032, NY, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Edward Sobek
- Assured Bio Laboratories, Oak Ridge, TN, 37830, USA
| | - Brett J Green
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Karen C Dannemiller
- Department of Civil, Environmental and Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, 43210, USA; Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, 43210, USA; Sustainability Institute, Ohio State University, Columbus, OH, 43210, USA
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Peters A, Hernández D, Kioumourtzoglou M, Johnson MA, Chillrud SN, Hilpert M. Assessing Neighborhood-scale Traffic from Crowd-sensed Traffic Data: Findings from an Environmental Justice Community in New York City. ENVIRONMENTAL SCIENCE & POLICY 2022; 133:155-163. [PMID: 35910007 PMCID: PMC9328407 DOI: 10.1016/j.envsci.2022.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The waterfront in the South Bronx in New York City is used industrially and harbors the Harlem River Yards (HRY). The HRY borders an environmental justice area, which includes a mixed-use area that is separated from a densely populated residential area by interstates. Recently, development of the HRY has expanded including the 2018 opening of a large online store warehouse. OBJECTIVE The goal of this study was to evaluate trends in traffic congestion nearby the HRY between 2017 to 2019. METHODS We analyzed one-hourly time series of crowd-sensed traffic congestion maps, both at the neighborhood scale and the road stretch level. Traffic radar measurements at two locations did not indicate bias in the crowd-sensed data over the study period, i.e., changed mappings between vehicle speed and the reported congestion. RESULTS In the mixed-use areas, traffic congestion increased significantly during all hours of the day, with greatest increases at night and in the morning. Congestion increased close to the entrances of the HRY and along routes used by pedestrians and bicyclists to access a nearby recreational area. In the residential area, congestion increased significantly from midnight to morning and was unchanged for the remainder of the day. On the interstates, congestion decreased during the daytime but increased at night. CONCLUSIONS Neighborhood-scale traffic congestion increased in mixed-use and residential areas in an environmental justice community. Our methods can be applied globally as long as crowd-sensed traffic data can be acquired. The data enable communities to advocate for mitigating measures.
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Affiliation(s)
- Anisia Peters
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University, 722 West 168th St., New York, NY 10032
- The City College of New York, 160 Convent Avenue, New York, NY 10031
| | - Diana Hernández
- Department of Sociomedical Sciences, Mailman School of Public Health Columbia University, 722 West 168th St., New York, NY 10032
| | - Marianthi Kioumourtzoglou
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University, 722 West 168th St., New York, NY 10032
| | | | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, 61 Rt 9W, Palisades, NY 10964
| | - Markus Hilpert
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University, 722 West 168th St., New York, NY 10032
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Multiomics to elucidate inflammatory bowel disease risk factors and pathways. Nat Rev Gastroenterol Hepatol 2022; 19:399-409. [PMID: 35301463 PMCID: PMC9214275 DOI: 10.1038/s41575-022-00593-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) is an immune-mediated disease of the intestinal tract, with complex pathophysiology involving genetic, environmental, microbiome, immunological and potentially other factors. Epidemiological data have provided important insights into risk factors associated with IBD, but are limited by confounding, biases and data quality, especially when pertaining to risk factors in early life. Multiomics platforms provide granular high-throughput data on numerous variables simultaneously and can be leveraged to characterize molecular pathways and risk factors for chronic diseases, such as IBD. Herein, we describe omics platforms that can advance our understanding of IBD risk factors and pathways, and available omics data on IBD and other relevant diseases. We highlight knowledge gaps and emphasize the importance of birth, at-risk and pre-diagnostic cohorts, and neonatal blood spots in omics analyses in IBD. Finally, we discuss network analysis, a powerful bioinformatics tool to assemble high-throughput data and derive clinical relevance.
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Nitrogen Dioxide Pollutant Exposure and Exercise-induced Bronchoconstriction in Urban Childhood Asthma: A Pilot Study. Ann Am Thorac Soc 2022; 19:139-142. [PMID: 34214020 PMCID: PMC8787788 DOI: 10.1513/annalsats.202103-254rl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Yamaguchi H, Nozu K, Ishiko S, Kondo A, Ninchoji T, Nagano C, Takeda H, Unzaki A, Ishibashi K, Morioka I, Nagase H, Iijima K, Ishida A. Impact of the State of Emergency during the COVID-19 Pandemic in 2020 on Asthma Exacerbations among Children in Kobe City, Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111407. [PMID: 34769923 PMCID: PMC8583023 DOI: 10.3390/ijerph182111407] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 12/21/2022]
Abstract
The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011–2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our emergency department, and 7476 were diagnosed with AE. The number of patients showed spring and fall peaks in 2011–2019. Multivariate analyses showed significant positive relationships of the number of AE patients with the average temperature among all patients and 0–5-year-olds and with sulfur dioxide (SO2) levels in 2011–2019 among 0–5-year-olds. Although the spring peak in the number of patients was not observed in 2020 after declaration of a state of emergency, the fall peak was again observed after the state of emergency was lifted. No changes in average temperature were detected, but SO2 was significantly reduced following declaration of the state of emergency in 2020. Therefore, SO2 reduction might have contributed to the disappearance of the peak of AE. However, a fall peak was observed again in 2020, although SO2 levels continued to be low. These data suggest that person to person interaction seems to be associated with AE, presumably due to unknown viral infections.
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Affiliation(s)
- Hiroshi Yamaguchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
- Correspondence: ; Tel.: +81-78-382-5111; Fax: +81-78-382-5050
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Shinya Ishiko
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Atsushi Kondo
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Takeshi Ninchoji
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Hiroki Takeda
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Ai Unzaki
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
| | - Kazuto Ishibashi
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1, Oyaguchi, Kami-cho, Itabashi-ku 173-8610, Japan;
| | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Akihito Ishida
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
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Camargos P, Watts KD. Inequalities and Inequities in Pediatric Respiratory Diseases. Pediatr Clin North Am 2021; 68:293-304. [PMID: 33228939 DOI: 10.1016/j.pcl.2020.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social inequality refers to disparities in society that have the effect of limiting a group's socioeconomic, educational, and intellectual potential. Inequity in health means any limitation to access comprehensive health services that also hinders the achievement of well-being and favorable health outcomes. Strategies for more equitable growth to eradicate global poverty would contribute to reducing health inequities and improve health care outcomes. Coordinated efforts between governments, private sector, families, and interested stakeholders are needed. This article discusses inequality and inequity in pediatric respiratory diseases, the challenges confronted, and the strategies needed to mitigate these disparities.
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Affiliation(s)
- Paulo Camargos
- Department of Pediatrics, Medical School, Pediatric Pulmonology Unit, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Kimberly Danieli Watts
- Division of Pediatric Pulmonary Medicine, Advocate Children's Hospital, Park Ridge, IL, USA; Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
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He J, Ghorveh MG, Hurst JH, Tang M, Alhanti B, Lang JE, Goldstein BA. Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data. BMC Public Health 2020; 20:1626. [PMID: 33121457 PMCID: PMC7599107 DOI: 10.1186/s12889-020-09731-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods To evaluate the impact of highway proximity, we assessed the association between asthma exacerbations and the distance of child’s primary residence to two types of roadways in Durham County, North Carolina, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6208 children with asthma between 2014 and 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results There was a no observed effect of residential distance from 55+ MPH highway (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)) and distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)) and any asthma exacerbation. Even those children living closest to highways (less 0.25 miles) had no increased risk of exacerbation. These results were consistent across different demographic strata. Conclusions While the results were non-significant, the characteristics of the study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to the lack of effect. Compared to previous studies, which often relied on self-reported measures, we were able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts on disease. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12889-020-09731-0.
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Affiliation(s)
- Jingyi He
- Department of Biostatistics & Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC, 27705, USA
| | | | - Jillian H Hurst
- Children's Health & Discovery Initiative, Duke University, Durham, NC, USA.,Department of Pediatrics, Duke University, Durham, USA
| | - Monica Tang
- Department of Medicine, University California, San Francisco, USA
| | | | - Jason E Lang
- Duke Clinical Research Institute, Durham, NC, USA.,Department of Pediatrics, Duke University, Durham, USA
| | - Benjamin A Goldstein
- Department of Biostatistics & Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC, 27705, USA. .,Duke Clinical Research Institute, Durham, NC, USA. .,Children's Health & Discovery Initiative, Duke University, Durham, NC, USA. .,Department of Pediatrics, Duke University, Durham, USA.
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The Role and Potential Pathogenic Mechanism of Particulate Matter in Childhood Asthma: A Review and Perspective. J Immunol Res 2020; 2020:8254909. [PMID: 32411804 PMCID: PMC7201641 DOI: 10.1155/2020/8254909] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 01/04/2020] [Indexed: 01/23/2023] Open
Abstract
Asthma, the most common chronic respiratory disease in children, affects numerous people worldwide. Accumulating evidence suggests that exposure to high levels of particulate matter (PM), either acutely or chronically, is associated with the exacerbation and incidence of pediatric asthma. However, the detailed pathogenic mechanisms by which PM contributes to the incidence of asthma remain largely unknown. In this short review, we summarize studies of relationships between PM and pediatric asthma and recent advances on the fundamental mechanisms of PM-related asthma, with emphases on cell death regulation and immune system responses. We further discuss the inadequacy of current studies and give a perspective on the prevention strategies for pediatric asthma.
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Kihal-Talantikite W, Le Nouveau P, Legendre P, Zmirou Navier D, Danzon A, Carayol M, Deguen S. Adverse Birth Outcomes as Indicators of Poor Fetal Growth Conditions in a French Newborn Population-A Stratified Analysis by Neighborhood Deprivation Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214069. [PMID: 31652714 PMCID: PMC6861961 DOI: 10.3390/ijerph16214069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/24/2022]
Abstract
Background: Adverse birth outcomes are related to unfavorable fetal growth conditions. A latent variable, named Favorable Fetal Growth Condition (FFGC), has been defined by Bollen et al., in 2013; he showed that this FFGC latent variable mediates the effects of maternal characteristics on several birth outcomes. Objectives: The objectives of the present study were to replicate Bollen’s approach in a population of newborns in Paris and to investigate the potential differential effect of the FFGC latent variable according to the neighborhood socioeconomic level. Methods: Newborn health data were available from the first birth certificate registered by the Maternal and Child Care department of the City of Paris. All newborns (2008–2011) were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level. Several mothers’ characteristics were collected from the birth certificates: age, parity, education and occupational status and the occupational status of the father. Three birth outcomes were considered: birth weight (BW), birth length (BL) and gestational age (GA). Results: Using a series of structural equation models, we confirm that the undirected model (that includes the FFGC latent variable) provided a better fit for the data compared with the model where parental characteristics directly affected BW, BL, and/or GA. However, the strength, the direction and statistical significance of the associations between the exogenous variables and the FFGC were different according to the neighborhood deprivation level. Conclusion: Future research should be designed to assess the how robust the FFGC latent variable is across populations and should take into account neighborhood characteristics to identify the most vulnerable group and create better design prevention policies.
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Affiliation(s)
- Wahida Kihal-Talantikite
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 6700 Strasbourg, France.
| | | | | | - Denis Zmirou Navier
- INSERM U1085 IRSET (Research Institute in Environmental and Occupational Health), Rennes, 35000 Cedex, France.
- Lorraine University Medical School, Nancy, 54052 Cedex, France.
| | - Arlette Danzon
- City of Paris Maternal and infant health department (PMI), 75018 Paris, France.
| | - Marion Carayol
- City of Paris Maternal and infant health department (PMI), 75018 Paris, France.
| | - Séverine Deguen
- EHESP School of Public Health, Rennes, 35043 Cedex, France.
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), 75646 Paris, France.
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Shin SW, Bae DJ, Park CS, Lee JU, Kim RH, Kim SR, Chang HS, Park JS. Effects of air pollution on moderate and severe asthma exacerbations. J Asthma 2019; 57:875-885. [PMID: 31122089 DOI: 10.1080/02770903.2019.1611844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Few studies have evaluated the impact of air pollution levels on the severity of exacerbations. Thus, we compared the relative risks posed by air pollutant levels on moderate and severe exacerbations.Methods: Exacerbation episodes of 618 from 143 adult asthmatics were retrospectively collected between 2005 and 2015 in a tertiary hospital of Korea. Air pollution GPS data for the location closest to each patient's home were obtained from the national ambient monitoring station. The relative impacts of air pollutants on asthma exacerbations were evaluated via a time-trend controlled symmetrical, bidirectional, case-crossover design using conditional logistic regression models on the day of the exacerbation (T-0) and up to 3 days before the exacerbation (T-1-T-3).Results: Overall asthma exacerbation were associated with O3 levels in summer and winter (OR: 1.012[1.003-1.02] and 1.009[1.003-1.016]), SO2 levels in spring and summer (OR: 1.009[1-1.018] and 1.02[1.006-1.035]) and NO2 levels in winter (OR: 1.007[1.003-1.011]). Analyses of the temporal relationship between O3 concentrations and exacerbations demonstrated that 63.2% of episodes in the summer occurred when the O3 concentrations on T-1 were significantly higher than those on control days, while 51% of exacerbation episodes in the winter occurred. Severe and moderate exacerbations were similarly associated with O3 levels in winter (OR: 1.012 [1.003-1.02] vs. 1.01 [0.999-1.021], p > 0.05) and in summer (OR: 1.006 [1.002-1.009] vs. 1.009 [1.003-1.016], p > 0.05).Conclusions: Asthma exacerbations may be associated with the seasonal elevation of O3, SO2 and NO2 levels in summer and winter with the similar relative risk between moderate and severe exacerbations.
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Affiliation(s)
- Seung-Woo Shin
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Da-Jeong Bae
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Jong-Uk Lee
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Ryun-Hee Kim
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Sung Roul Kim
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea
| | - Hun-Soo Chang
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Jong Sook Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
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