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

Autor: Dhingra R; Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, C.B 7431, Chapel Hill, NC, 27599, USA. RDhingra@unc.edu.; Brody School of Medicine, East Carolina University, Greenville, NC, USA. RDhingra@unc.edu., Keeler C; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Staley BS; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Jardel HV; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA., Ward-Caviness C; Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA., Rebuli ME; Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Xi Y; Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, C.B 7431, Chapel Hill, NC, 27599, USA., Rappazzo K; Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA., Hernandez M; Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Chelminski AN; Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA., Jaspers I; Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Rappold AG; Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, Durham, NC, USA.
Jazyk: angličtina
Zdroj: Environmental health : a global access science source [Environ Health] 2023 Jun 27; Vol. 22 (1), pp. 48. Date of Electronic Publication: 2023 Jun 27.
DOI: 10.1186/s12940-023-00998-5
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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