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Evaluation of evidence for interaction between PM2.5 and aeroallergens on childhood asthma exacerbation in Philadelphia, PA, 2011 to 2016.
Huang, Wanyu; Schinasi, Leah H; Kenyon, Chén C; Auchincloss, Amy H; Moore, Kari; Melly, Steven; Robinson, Lucy F; Forrest, Christopher B; De Roos, Anneclaire J.
Afiliación
  • Huang W; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA. Electronic address: wh397@drexel.edu.
  • Schinasi LH; Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, PA, USA; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
  • Kenyon CC; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
  • Auchincloss AH; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
  • Moore K; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
  • Melly S; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
  • Robinson LF; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
  • Forrest CB; The Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
  • De Roos AJ; Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, PA, USA; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Environ Res ; 234: 116395, 2023 10 01.
Article en En | MEDLINE | ID: mdl-37390950
Fine particulate matter (PM2.5) and aeroallergens (i.e., pollen, molds) are known triggers of asthma exacerbation. Despite mechanistic evidence suggesting synergistic effects between PM2.5 and asthma exacerbation, little epidemiologic work has been performed in children, which has exhibited inconsistency. We conducted a time-series study to explore their interactions using electronic health records (EHR) data in Philadelphia, PA, for asthma diagnoses in outpatient, emergency department [ED], and inpatient settings. Daily asthma exacerbation cases (28,540 asthma exacerbation case encounters) were linked to daily ambient PM2.5 and daily aeroallergen levels during the aeroallergen season of a six-year period (mid-March to October 2011-2016). Asthma exacerbation counts were modeled using quasi-Poisson regression, where PM2.5 and aeroallergens were fitted with distributed lag non-linear functions (lagged from 0 to 14-days), respectively, when modeled as the primary exposure variables. Regression models were adjusted for mean daily temperature/relative humidity, long-term and seasonal trends, day-of-week, and major U.S. holidays. Increasing gradient of RR estimates were observed for only a few primary exposure risk factors [PM2.5 (90th vs. 5th percentile)/aeroallergens (90th percentile vs. 0)], across different levels of effect modifiers. For example, RRs for the association between late-season grass pollen (lag1) and asthma exacerbation were higher at higher levels of PM2.5, 5-days preceding the exacerbation event (low PM2.5: RR = 1.01, 95% CI: 0.93-1.09; medium PM2.5: 1.04, 95% CI: 0.96-1.12; high PM2.5: 1.09, 95% CI: 1.01-1.19). However, most of the highest RRs for aeroallergens were instead observed for days with low- or medium- PM2.5 levels; likewise, when PM2.5 was modeled as the primary exposure with aeroallergens as the effect modifier. Most of the RR estimates did not exhibit gradients that suggested synergism, and were of relatively high imprecision. Overall, our study suggested no evidence for interactions between PM2.5 and aeroallergens in their relationships with childhood asthma exacerbation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Contaminantes Atmosféricos / Contaminación del Aire Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Environ Res Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Contaminantes Atmosféricos / Contaminación del Aire Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Environ Res Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos