Abstract
Ongoing climate change is affecting the health of communities across the globe. While direct consequences, including morbidity and mortality tied to increases in the frequency of extreme weather events, have received significant attention, indirect health effects, particularly those associated with climate change-driven disruptions in ecosystems, are less understood. To investigate how ongoing changes in the timing of spring onset related to climate change are associated with rates of asthma hospitalization in Maryland. This cross-sectional study of 29 257 patients with asthma used general additive (quasi Poisson) and mixed-effect (negative binomial) models to investigate the association between changes in the timing of spring onset, detected using satellite observations, and the risk of asthma hospitalization in Maryland from 2001 to 2012. Data analysis was conducted from January 2016 to March 2019. Phenology data, derived from the National Aeronautics and Space Administration's Moderate Resolution Imaging Spectroradiometer, were used to calculate location-specific median dates for start of season from 2001 to 2012. How the start of season for a given year and location deviated from the long-term average was calculated and categorized as very early, early, normal, or late. Daily asthma hospitalization in Maryland during the spring season (ie, March to May). There were 108 358 total asthma hospitalizations during the study period, of which 29 257 (27.0%; 14 379 [49.1%] non-Hispanic black patients; 17 877 [61.1%] women) took place during springtime. In the unadjusted model, very early (incident rate ratio [IRR], 1.17; 95% CI, 1.07-1.28) and late (IRR, 1.07; 95% CI, 1.00-1.15) onset of spring were associated with increased risk of asthma hospitalization. When the analysis was adjusted for extreme heat events and concentrations of particulate matter with an aerodynamic diameter less than 2.5 μm, the risk remained significant for very early spring onset (IRR, 1.10; 95% CI, 1.02-1.20) but not for late spring onset (IRR, 1.03; 95% CI, 0.97-1.11). These results suggest that ongoing changes in the timing of spring onset, which are related to climate variability and change, are associated with asthma hospitalization. Given the high burden of allergic diseases and the number of individuals sensitized to tree pollen, these findings serve as a wake-up call to public health and medical communities regarding the need to anticipate and adapt to the ongoing changes in the timing and severity of the spring allergy season.
Highlights
Previous studies have linked attributes of climate change, such as increased frequency of extreme heat, drought, hurricanes, flooding, and wildfires, with both chronic and acute health outcomes.[1,2] there is a paucity of data regarding how climate-induced ecological changes, such as vegetation phenology and the timing of spring onset, may affect the burden of allergic diseases.Phenological events, such as dormancy, bud formation, and flowering among temperate deciduous trees, are related to environmental cues, including photoperiod and temperature.[3,4] While the photoperiod at a given location remains the same, the temperature cue has undergone considerable change during the past several decades in response to climate change.[3]
Very early and late (IRR, 1.07; 95% CI, 1.00-1.15) onset of spring were associated with increased risk of asthma hospitalization
When the analysis was adjusted for extreme heat events and concentrations of particulate matter with an aerodynamic diameter less than 2.5 μm, the risk remained significant for very early spring onset (IRR, 1.10; 95% CI, 1.02-1.20) but not for late spring onset (IRR, 1.03; 95% CI, 0.97-1.11)
Summary
Previous studies have linked attributes of climate change, such as increased frequency of extreme heat, drought, hurricanes, flooding, and wildfires, with both chronic and acute health outcomes.[1,2] there is a paucity of data regarding how climate-induced ecological changes, such as vegetation phenology and the timing of spring onset, may affect the burden of allergic diseases.Phenological events, such as dormancy, bud formation, and flowering among temperate deciduous trees, are related to environmental cues, including photoperiod and temperature.[3,4] While the photoperiod at a given location remains the same, the temperature cue has undergone considerable change during the past several decades in response to climate change.[3]. Previous studies have linked attributes of climate change, such as increased frequency of extreme heat, drought, hurricanes, flooding, and wildfires, with both chronic and acute health outcomes.[1,2] there is a paucity of data regarding how climate-induced ecological changes, such as vegetation phenology and the timing of spring onset, may affect the burden of allergic diseases. Others have suggested such phenological changes to be the most sensitive indicator of ecological response to climate change.[6,18,19,20,21]
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