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Straub A, Fricke V, Olschewski P, Seubert S, Beck C, Bayr D, Kolek F, Plaza MP, Leier-Wirtz V, Kaschuba S, Traidl-Hoffmann C, Buermann W, Gerstlauer M, Damialis A, Philipp A. The phenomenon of thunderstorm asthma in Bavaria, Southern Germany: a statistical approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2678-2694. [PMID: 34607495 DOI: 10.1080/09603123.2021.1985971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Higher incidences of asthma during thunderstorms can pose a serious health risk. In this study, we estimate the thunderstorm asthma risk using statistical methods, with special focus on Bavaria, Southern Germany. In this approach, a dataset of asthma-related emergency cases for the study region is combined with meteorological variables and aeroallergen data to identify statistical relationships between the occurrence of asthma (predictand) and different environmental parameters (set of predictors). On the one hand, the results provide evidence for a weak but significant relationship between atmospheric stability indices and asthma emergencies in the region, but also show that currently thunderstorm asthma is not a major concern in Bavaria due to overall low incidences. As thunderstorm asthma can have severe consequences for allergic patients, the presented approach can be important for the development of emergency strategies in regions affected by thunderstorm asthma and under present and future climate change conditions.
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Affiliation(s)
- Annette Straub
- Institute for Geography, University of Augsburg, Augsburg, Germany
| | - Verena Fricke
- Institute for Geography, University of Augsburg, Augsburg, Germany
| | - Patrick Olschewski
- Professorship for Regional Climate Change and Health, University of Augsburg, Augsburg, Germany
| | - Stefanie Seubert
- Institute for Geography, University of Augsburg, Augsburg, Germany
| | - Christoph Beck
- Institute for Geography, University of Augsburg, Augsburg, Germany
| | - Daniela Bayr
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Franziska Kolek
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Maria P Plaza
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Vivien Leier-Wirtz
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Sigrid Kaschuba
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Claudia Traidl-Hoffmann
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | - Michael Gerstlauer
- Department of Pediatric Pneumology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Athanasios Damialis
- German Research Centre for Environmental Health, Chair and Institute of Environmental Medicine, Technical University of Munich and Helmholtz Centre Munich, Augsburg, Germany
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Andreas Philipp
- Institute for Geography, University of Augsburg, Augsburg, Germany
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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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Spina MF, Banfi PI, Nicolini A. Thunderstorm-asthma, two cases observed in Northern Italy. Multidiscip Respir Med 2020; 15:679. [PMID: 32983454 PMCID: PMC7499097 DOI: 10.4081/mrm.2020.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/23/2020] [Indexed: 11/23/2022] Open
Abstract
Thunderstorm asthma is a rare event: in this letter we describe two cases observed during the same month of 2018 at an Italian Emergency department, assessed by the same medical team and according to the same methodology and approach. Given the infrequency of such a phenomenon and the debate around its nature, frequency, and - at times - existence, we strongly believe it is important for all specialists who observe such cases to report them, building an evidence base to expand its knowledge and understanding.
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Affiliation(s)
| | | | - Antonello Nicolini
- Respiratory Diseases Unit, General Hospital of Sestri Levante (GE), Italy
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Caminati M, Vianello A, Ricci G, Festi G, Bellamoli R, Longhi S, Crivellaro M, Marcer G, Monai M, Andretta M, Bovo C, Senna G. Trends and determinants of Emergency Room admissions for asthma: A retrospective evaluation in Northeast Italy. World Allergy Organ J 2019; 12:100046. [PMID: 31320967 PMCID: PMC6612754 DOI: 10.1016/j.waojou.2019.100046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/18/2019] [Accepted: 06/10/2019] [Indexed: 01/21/2023] Open
Abstract
Background Asthma still represents a cause of death and hospital admissions worldwide. Our study aimed at analyzing the trend of Emergency Room (ER) asthma admissions in Northeast Italy in order to investigate the relevance of specific patient-related determinants and environmental triggers (pollens, mold spores, and pollutants). Methods Retrospective data from admissions for asthma exacerbations registered between the years 2013 and 2015 in two main ERs in Northeast Italy were collected. Data about patients' age, sex and nationality were recorded. Classification of disease severity followed the current Italian ER triage scoring system (white: no need for emergency treatment; green: need for fast treatment; yellow: severe condition; red: life-threatening condition). Data on pollen/mold spore counts and pollutants were analyzed. Results Overall, 1745 ER admissions for asthma were registered, with a persistent and significant increase year by year. A slight prevalence of females and patients over 50 years old was observed. Immigrants accounted for 32%, 36% and 26% of admissions respectively in 2013, 2014 and 2015. The prevalence of immigrants' admissions was significantly higher when comparing the relative ratio of immigrant populations/Italian nationals (p < 0.05). The admissions were coded as follows: white, 6.30%; green, 35.36%; yellow, 39.37%; red, 18.97%. People aged ≥50 years were more frequently admitted with a red code, but the trend was not statistically significant (p = 0,0815). By contrast, amongst immigrants there was a higher prevalence of white and green codes observed in comparison with Italian nationals. Grass pollen peak and PM10 high levels represented environmental determinants of ER admissions increase. Conclusions The increasing rate of asthma-related ER admissions highlights the need for implementing asthma control strategies. Investigating the traits of patients referring to ER for asthma exacerbations, as well as environmental-related determinants, may help in identifying at-risk individuals and in orienting preventive strategies accordingly. Immigrants represent the most vulnerable sub-population, and their potential difficulties in accessing treatments and health services should be specifically addressed. Overall, implementing patient education in order to improve treatment adherence, as well as providing an asthma action plan to every asthmatic patient, continue to be the most urgent needs.
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Affiliation(s)
- Marco Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy.,Department of Medicine, University of Verona, Verona, Italy
| | - Andrea Vianello
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - Giorgio Ricci
- Emergency Department, Clinical Toxicology Unit, Verona University and General Hospital, Verona, Italy
| | - Giuliana Festi
- Respiratory Unit and Asthma Center, Verona University and General Hospital, Verona, Italy
| | - Roberto Bellamoli
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - Sofia Longhi
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - Mariangiola Crivellaro
- Allergy Service, Department of Medicine and Public Health, University of Padua, Padua, Italy
| | - Guido Marcer
- Respiratory Unit and Asthma Center, Verona University and General Hospital, Verona, Italy
| | - Marco Monai
- Meteorological Service, Veneto Regional Agency for Environment Protection and Prevention, Padua, Italy
| | | | - Chiara Bovo
- Medical Direction, Verona University and General Hospital, Verona, Italy
| | - Gianenrico Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
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