Association between hospitalizations for asthma exacerbation and weather conditions in Qingdao: an ecological study

Wei Han; Yi Su; Binglin Liu; Wenjing Zhu; Xinjuan Yu; Xiaohui Sun; Xuefei Qi; Xiaopei Lin; Syed A A Rizvi; Woo-Jung Song; Ji-Hyang Lee; Yasuo Shimizu; Ziguang Li; Qinghai Li

doi:10.21037/atm-22-1755

Association between hospitalizations for asthma exacerbation and weather conditions in Qingdao: an ecological study

Ann Transl Med. 2022 Apr;10(7):420. doi: 10.21037/atm-22-1755.

Authors

Wei Han^#¹, Yi Su^#¹, Binglin Liu², Wenjing Zhu³, Xinjuan Yu³, Xiaohui Sun⁴, Xuefei Qi¹, Xiaopei Lin⁵, Syed A A Rizvi⁶, Woo-Jung Song⁷, Ji-Hyang Lee⁷, Yasuo Shimizu⁸, Ziguang Li⁵, Qinghai Li¹

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
² Quality Improvement Department, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
³ Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
⁴ Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China.
⁵ Frontier Science Center for Deep Ocean Multispheres and Earth System (FDOMES) and Physical Oceanography Laboratory, Ocean University of China, Qingdao, China.
⁶ College of Biomedical Sciences, Larkin University, Miami, FL, USA.
⁷ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
⁸ Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, Japan.

^# Contributed equally.

Abstract

Background: The hospitalization for asthma exacerbation has varied with seasons, however, the underlying weather reasons have not been fully explored yet. This study is aimed to explore the effect of weather factors on increased number of hospitalization due to worsening of asthma symptoms. This will provide more information to the relevant authorities to allocate appropriate medical resources as per the weather conditions in Qingdao, China.

Methods: All adult patients admitted for asthma exacerbation from 1 January, 2017 to 31 December, 2019 were enrolled from 13 main hospitals of Qingdao. The clinical data, including age, sex, smoking history, etc., were collected from the electronic medical record (EMR) systems. The hourly air quality of Qingdao from 2017-2019, including the air quality index (AQI), PM_2.5 and PM₁₀, was obtained from the China National Environmental Monitoring Centre. All these parameters during 2017-2019 were compared monthly. For meteorological data, the monthly horizontal wind at 850 hPa and vertical velocity at 500 hPa during 1960-2020 were obtained from National Center for Environmental Prediction (NCEP) and the National Center for Atmospheric Research (NCAR) global reanalysis dataset. The correlation analysis was applied to determine the association between asthma hospitalizations and the environmental factors, including atmospheric pressure, humidity, vertical visibility, and etc., monthly.

Results: In all, 10,549 asthmatic inpatients (45.7% males, 54.3% females) were included in the study. The inpatients number for asthma exacerbation had a plateau lasting from March to June of 2019, accompanied with high PM_2.5 and PM₁₀, as well as bad air quality from January to March of 2019, potentially governed by the El Niño event in 2018. However, there was no significance correlation between the number of asthma hospitalizations and the average value of all environmental factors.

Conclusions: The high rate of hospitalization for asthma exacerbation in Qingdao during the spring of 2019 was associated with the unfavorable weather conditions, which might be linked to the atmospheric circulation in East Asia.

Keywords: Asthma exacerbation; climate change; pollution; weather condition.