Background: Few studies have explored the role of ambient temperature in asthma exacerbation. Objective: We aimed to explore the association of temperature with diurnal peak expiratory flow (PEE) variation and asthma exacerbation. Method: We developed a longitudinal study among asthmatic adults in 18 Chinese cities. Subjects recorded PEF in dynamic pulmonary function monitoring from 2017 to 2020. Linear mixed-effect model and generalized additive model with distributed non-linear models were used to assess the effect of temperature and temperature change between neighboring days (TCN) on diurnal PEE variation and the risk of asthma exacerbation. Result: We evaluated a total of 79,217 daily PEF monitoring records from 4467 adult asthmatic patients. 'I'here were significant increase of diurnal PEF variation and higher risk of asthma exacerbation with cold and sudden temperature drop. Compared with the referent temperature (99th percentile, 32 degrees C), exposure to moderate cold (25th percentile, 3 degrees C) and extreme cold (2.5th percentile, -7 degrees C) was associated with elevations of 1.28% and 1.16% in diurnal PEF variation over lag 0-2 days, respectively. The odds ratios of asthma exacerbation (determined by diurnal PEF variation >20%) at the two temperature cutoffs were 1.68 and 1.73. A sudden temperature drop (2.5th percentile of TCN, -5 degrees C) was associated with 1.13% elevation in diurnal PEF variation, and with increased risk of asthma exacerbation (odd ratio = 1.50) over lag 0-4 days. Conclusion: This large multicenter study pmvidcd the first-hand empirical evidence that cold temperature and a temperature drop may increase the risk of asthma exacerbation.
基金：
International Science and Technology Partnership Project of Shanghai Committee of Science and Technology [21230780200]; National Natural Science Foundation of China [92043301, 91843302]
通讯机构：[1]Fudan Univ, Sch Publ Hlth, Key Lab Publ Hlth Safety Minist Educ, NHC Key Lab Hlth Technol Assessment, Shanghai, Peoples R China[7]Fudan Univ, IRDR ICoE Risk Interconnect & Governance Weather, Shanghai, Peoples R China[8]Shanghai Typhoon Inst, Shanghai Key Lab Meteorol & Hlth, CMA, Shanghai 200030, Peoples R China[*1]Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
推荐引用方式(GB/T 7714)：
Zhu Yixiang,Yang Ting,Huang Suijie,et al.Cold temperature and sudden temperature drop as novel risk factors of asthma exacerbation: a longitudinal study in 18 Chinese cities[J].SCIENCE of the TOTAL ENVIRONMENT.2022,814:doi:10.1016/j.scitotenv.2021.151959.
APA：
Zhu, Yixiang,Yang, Ting,Huang, Suijie,Li, Huichu,Lei, Jian...&Chen, Renjie.(2022).Cold temperature and sudden temperature drop as novel risk factors of asthma exacerbation: a longitudinal study in 18 Chinese cities.SCIENCE of the TOTAL ENVIRONMENT,814,
MLA：
Zhu, Yixiang,et al."Cold temperature and sudden temperature drop as novel risk factors of asthma exacerbation: a longitudinal study in 18 Chinese cities".SCIENCE of the TOTAL ENVIRONMENT 814.(2022)
环境科学与生态学