Wildfire smoke exposure and early childhood respiratory health: a study of prescription claims data

被引：14

作者：

Dhingra, Radhika ^{[1
,2
]}

Keeler, Corinna ^{[3
]}

Staley, Brooke S. S. ^{[3
]}

Jardel, Hanna V. V. ^{[3
,4
]}

Ward-Caviness, Cavin ^{[4
]}

Rebuli, Meghan E. E. ^{[5
,6
]}

Xi, Yuzhi ^{[1
]}

Rappazzo, Kristen ^{[4
]}

Hernandez, Michelle ^{[5
]}

Chelminski, Ann N. N. ^{[4
]}

Jaspers, Ilona ^{[5
,6
]}

Rappold, Ana G. G. ^{[4
]}

机构：

[1] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Environm Sci & Engn, 135 Dauer Dr,CB 7431, Chapel Hill, NC 27599 USA

[2] East Carolina Univ, Brody Sch Med, Greenville, NC 27858 USA

[3] Univ North Carolina Chapel Hill, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC USA

[4] United States Environm Protect Agcy, Ctr Publ Hlth & Environm Assessment, Durham, NC USA

[5] Univ North Carolina Chapel Hill, Sch Med, Dept Pediat, Chapel Hill, NC USA

[6] Univ North Carolina Chapel Hill, Ctr Environm Med Asthma & Lung Biol, Chapel Hill, NC USA

来源：

ENVIRONMENTAL HEALTH | 2023年 / 22卷 / 01期

关键词：

Wildfire; Wildfire smoke; Smoke exposure; Prenatal; Perinatal; Childhood respiratory disease; Prescription claims; SOUTHERN CALIFORNIA WILDFIRES; FINE PARTICULATE MATTER; AIR-POLLUTION; LUNG-FUNCTION; HOSPITAL ADMISSIONS; RISK-FACTOR; WOOD SMOKE; CHILDREN; BIRTH; FIRE;

D O I：

10.1186/s12940-023-00998-5

中图分类号：

X [环境科学、安全科学];

学科分类号：

08 ; 0830 ;

摘要：

Wildfire smoke is associated with short-term respiratory outcomes including asthma exacerbation in children. As investigations into developmental wildfire smoke exposure on children's longer-term respiratory health are sparse, we investigated associations between developmental wildfire smoke exposure and first use of respiratory medications. Prescription claims from IBM MarketScan Commercial Claims and Encounters database were linked with wildfire smoke plume data from NASA satellites based on Metropolitan Statistical Area (MSA). A retrospective cohort of live infants (2010-2016) born into MSAs in six western states (U.S.A.), having prescription insurance, and whose birthdate was estimable from claims data was constructed (N = 184,703); of these, gestational age was estimated for 113,154 infants. The residential MSA, gestational age, and birthdate were used to estimate average weekly smoke exposure days (smoke-day) for each developmental period: three trimesters, and two sequential 12-week periods post-birth. Medications treating respiratory tract inflammation were classified using active ingredient and mode of administration into three categories:: 'upper respiratory', 'lower respiratory', 'systemic anti-inflammatory'. To evaluate associations between wildfire smoke exposure and medication usage, Cox models associating smoke-days with first observed prescription of each medication category were adjusted for infant sex, birth-season, and birthyear with a random intercept for MSA. Smoke exposure during postnatal periods was associated with earlier first use of upper respiratory medications (1-12 weeks: hazard ratio (HR) = 1.094 per 1-day increase in average weekly smoke-day, 95%CI: (1.005,1.191); 13-24 weeks: HR = 1.108, 95%CI: (1.016,1.209)). Protective associations were observed during gestational windows for both lower respiratory and systemic anti-inflammatory medications; it is possible that these associations may be a consequence of live-birth bias. These findings suggest wildfire smoke exposure during early postnatal developmental periods impact subsequent early life respiratory health.

引用

页数：13

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