한빛사 논문
Seung Won Lee MD, PhD1,2,†, Dong Keon Yon MD3,4,†, Chase C. James MSc5, Shinhae Lee MD3, Hyun Yong Koh MD, PhD6, Youn Ho Sheen MD, PhD7, Jae-Won Oh MD, PhD8, Man Yong Han MD, PhD3,*, George Sugihara PhD5
1 CHA University School of Medicine, Seongnam, Republic of Korea
2 Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
3 Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
4 Medical Corps, Republic of Korea Army, Seongnam, Republic of Korea
5 Scripps Institution of Oceanography, University of California San Diego, California, USA
6 F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
7 Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
8 Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
*Corresponding author: Man Yong Han
†Seung Won Lee and Dong Keon Yon contributed equally to this work.
Abstract
Background
Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to the environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs.
Objective
To examine the short-term effects of age-stratified groups (infants, preschool children, school-aged children, adults, and elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on asthma exacerbations.
Methods
We performed an age-stratified analysis of the short-term effects of four groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis employed a Poisson generalized linear regression model, with a distributed lag non-linear model for identification of lagged and non-linear effects and convergent cross mapping for identification of causal associations.
Results
Analysis of the total population (n=10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly people (RR: 1.056-1.078 and 1.016, respectively). Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-age children (RR: 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR: 1.026 and 1.044, respectively). Outdoor air pollutants (PM10, NO2, O3, CO, and SO2) had significant short-term effects in all age groups (except for CO and SO2 in infants).
Conclusion
These findings provide the need for the development of tailored strategies to prevent asthma exacerbation events in different age groups.
Keywords : Asthma exacerbation; air pollutant; weather condition; aeroallergen; human rhinovirus; influenza virus
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