1. Interactions between climate factors and air quality index for improved childhood asthma self-management
- Author
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Jiaojiao Gao, Zihan Xu, Xiangguo Liu, Jun Duan, Yanfeng Zou, Shasha Son, Yangyang He, Yu Zhou, Qiannan Wei, Xu Wang, Chao Tang, Hong Su, Yanhu Ji, Rubing Pan, and Weizhuo Yi
- Subjects
Male ,Environmental Engineering ,010504 meteorology & atmospheric sciences ,Context (language use) ,010501 environmental sciences ,Interaction ,01 natural sciences ,Stratified analysis ,Air Pollution ,Environmental health ,Humans ,Environmental Chemistry ,Medicine ,Child ,Waste Management and Disposal ,Air quality index ,0105 earth and related environmental sciences ,Air Pollutants ,Childhood asthma ,business.industry ,Self-Management ,Absolute risk reduction ,Humidity ,Pollution ,Asthma ,Hospitalization ,Increased risk ,Child, Preschool ,Relative risk ,Female ,business - Abstract
Background Daily air quality index (AQI) forecast can provide early warning information, and it is not clear whether it is appropriate for childhood asthma hospitalizations (CAHs). Furthermore, little is known about the effects of AQI on CAHs, as well as the interactions between temperature, humidity and AQI. Methods We collected 32,238 cases in Hefei from 2013 to 2016 and estimated the association between daily CAHs and AQI by combining the Poisson Generalized Linear Models (PGLMs) with the Distributed Lag Nonlinear Models (DLNMs). The interaction between AQI and temperature was tested by stratifying AQI and temperature, as well as humidity. Results AQI was associated with an increased risk of hospitalizations for childhood asthma. The adverse effect first appeared on the 3rd day, with the RR of 1.011 (95%CI: 1.000–1.023) and continued until the 19th day of lag (RR = 1.010, 95%CI: 1.001–1.020). In the subgroup analysis, the male and pre-school children were more sensitive to AQI, and there are seasonal differences in the effects of AQI on CAHs. Besides, in a stratified analysis with an AQI of 150, we found synergies between temperature, humidity and AQI. The interaction relative risk (IRR) and relative excess risk due to interaction (RERI) for the interaction between temperature and AQI were 1.157 (95%CI: 1.029–1.306) and 0.122 (95%CI: 0.022–0.223) respectively. For the humidity, the IRR and RERI were 1.090 (95%CI: 1.056–1.206) and 0.083 (95%CI: 0.083–0.143) respectively. Exploring different subgroups in the interaction analyses, it was worth noting that female and pre-school children were more sensitive to the interaction between AQI and temperature, while school-age children were more sensitive to the interaction between AQI and humidity. Conclusions The study found that not only AQI can significantly increase the risk of CAHs, but also that under the context of climate change, temperature and humidity have a synergistic effect on AQI, suggesting that considering only the warning information of air pollution is not enough to strengthen the prevention of childhood asthma hospitalization.
- Published
- 2020