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Climate interactions and respiratory diseases in children
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Introdução: Fatores meteorológicos como temperatura e humidade relativa podem afetar a saúde, particularmente o sistema respiratório. As crianças representam um grupo de risco, pela sua imaturidade, dificuldades de adaptação, crescimento e desenvolvimento contínuos. A asma é a doença crónica mais comum, e as infeções respiratórias uma grande causa de morbilidade e mortalidade infantil.
Objetivos: Analisar os efeitos da temperatura e humidade relativa nos internamentos pediátricos por exacerbações de asma e infeções respiratórias.
Métodos: Este estudo retrospetivo analisou dados administrativos de internamentos por infeções respiratórias e/ou asma, entre 2018 e 2020, no Serviço de Pediatria do Hospital de Santa Maria. Correlações de Pearson, Spearman, e os testes T-Student, ANOVA e correspondentes não paramétricos foram usados para determinar associações entre variáveis climáticas e internamentos. Foram feitos modelos do número diário de internamentos previstos usando a Regressão Binominal Negativa.
Resultados: Registaram-se 338 crianças e 369 registos clínicos de diagnósticos primários e secundários. Em 2020 verificou-se uma redução de internamentos pela pandemia COVID-19. Dos 369 diagnósticos, 58,9% eram do sexo masculino, idade média 3,1±5,2 anos. Dos diagnósticos, 51,2% eram Infeções Respiratórias Baixas virais, 17,9% Asma, 16,3% Infeções Respiratórias Altas e 14,6% Infeções Respiratórias Baixas não-virais. As médias diárias de temperatura média foram 14,8±4,0ºC e humidade relativa 77,7±12,7%. Verificou-se correlação negativa com a temperatura máxima (p=0,012) e positiva com a humidade relativa média (p=0,045). O grupo Infeções Respiratórias Baixas virais tem associação significativa com hospitalizações, que aumenta quando as temperaturas médias são <10,0ºC e humidade relativa >86,67%. Finalmente, o melhor modelo mostra que quando a temperatura média diária aumenta, os internamentos diminuem (Relação Taxa Incidência=0,989).
Conclusão: Neste estudo, o frio e humidade elevada estão associados a internamentos infantis por asma e infeções respiratórias, especialmente virais. O estudo de outras variáveis (ex: poluentes) podem identificar outros fatores e promover a prevenção e planeamento em saúde.
Introduction: Meteorological factors like temperature and relative humidity can affect health, particularly the respiratory system. Children represent a risk group, due to immature systems, difficult adaptation, continual growth and development. Asthma is the most common chronic disease, and respiratory infections are a leading cause of childhood mortality and morbidity. Objectives: To analyse the effects of temperature and relative humidity on children’s hospitalizations due to asthma exacerbations and respiratory infections. Methods: This retrospective study analysed administrative data from 2018 to 2020, admitted to the Paediatric Service at Hospital de Santa Maria with respiratory infections and/or asthma exacerbations. Pearson’s and Spearman’s correlations, T-Student’s, ANOVA and the equivalent non-parametric tests were used to describe associations between climate variables and admissions. The Negative Binominal Regression was used to model the number of daily expected hospitalizations. Results: We found 338 children and 369 clinical records of primary and secondary discharge diagnoses. In 2020 there was a reduction in admissions, due to the COVID-19 pandemic. From the 369 episodes, 58.9% were male, mean age 3.1±5.2 years old. Of the total diagnoses, 51.2% were Lower Respiratory Infections viral, 17.9% Asthma, 16.3% Upper Respiratory Infections and 14.6% Lower Respiratory Infections non-viral. Mean average daily temperature was 14.8±4.0ºC and relative humidity 77.7±12.7%. We found a negative correlation between hospitalizations and maximum temperature (p=0.012) and positive with mean relative humidity (p=0.045). A significant association with hospitalizations was found in the Lower Respiratory Infections Viral group, when mean temperatures are <10.0ºC and relative humidity >86.67%. Finally, our best model showed that as daily mean temperature increases, the hospitalizations decreases (Incidence Rate Ratio=0.989). Conclusion: In our study, cold and high humidity levels were associated with childhood hospitalizations for asthma and respiratory infections, especially viral. Studies with other variables (e.g.: pollutants) may identify other factors more precisely and advocate prevention and health planning.
Introduction: Meteorological factors like temperature and relative humidity can affect health, particularly the respiratory system. Children represent a risk group, due to immature systems, difficult adaptation, continual growth and development. Asthma is the most common chronic disease, and respiratory infections are a leading cause of childhood mortality and morbidity. Objectives: To analyse the effects of temperature and relative humidity on children’s hospitalizations due to asthma exacerbations and respiratory infections. Methods: This retrospective study analysed administrative data from 2018 to 2020, admitted to the Paediatric Service at Hospital de Santa Maria with respiratory infections and/or asthma exacerbations. Pearson’s and Spearman’s correlations, T-Student’s, ANOVA and the equivalent non-parametric tests were used to describe associations between climate variables and admissions. The Negative Binominal Regression was used to model the number of daily expected hospitalizations. Results: We found 338 children and 369 clinical records of primary and secondary discharge diagnoses. In 2020 there was a reduction in admissions, due to the COVID-19 pandemic. From the 369 episodes, 58.9% were male, mean age 3.1±5.2 years old. Of the total diagnoses, 51.2% were Lower Respiratory Infections viral, 17.9% Asthma, 16.3% Upper Respiratory Infections and 14.6% Lower Respiratory Infections non-viral. Mean average daily temperature was 14.8±4.0ºC and relative humidity 77.7±12.7%. We found a negative correlation between hospitalizations and maximum temperature (p=0.012) and positive with mean relative humidity (p=0.045). A significant association with hospitalizations was found in the Lower Respiratory Infections Viral group, when mean temperatures are <10.0ºC and relative humidity >86.67%. Finally, our best model showed that as daily mean temperature increases, the hospitalizations decreases (Incidence Rate Ratio=0.989). Conclusion: In our study, cold and high humidity levels were associated with childhood hospitalizations for asthma and respiratory infections, especially viral. Studies with other variables (e.g.: pollutants) may identify other factors more precisely and advocate prevention and health planning.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Crianças Asma Infeções respiratórias agudas Temperatura Humidade relativa Pediatria