Trends in seasonal pollen and asthma-related morbidity among adults and children in a U.S. high-density urban center, 2001-2020

To analyze the long-term trends in pollen counts and asthma-related emergency department visits (AREDV) in adult and pediatric populations in the Bronx. Daily values of adult and pediatric AREDV were retrospectively obtained from three major Bronx hospitals using ICD-10 codes and pollen counts were obtained from the Armonk station from 2001–2020. Wilcoxon Ranked Sum was applied to compare median values, while Spearman correlation was employed to examine the association between these variables, for both decades and each season. The median value of pediatric AREDV increased by 200% from the 1st to 2nd decade (<i>p</i> &lt; 0.001) and AREDV peak shifted from predominantly the spring season in the 1st decade to the fall and winter seasons in the 2nd decade. Seasonal patterns were consistent over 20 years with summer AREDV lower than all other seasons (9 vs. 17 per day) (<i>p</i> &lt; 0.001). Spring tree pollen peaks were correlated with AREDV peaks (rho = 0.34) (<i>p</i> &lt; 0.001). Tree pollen exceeding 100 grains/m³ corresponded to a median of 19.0 AREDVs while all other tree pollen (0 − 99 grains/m³) corresponded to a median of 15.0 AREDVs (<i>p</i> &lt; 0.001). AREDVs sharply declined in 2020, coinciding with the emergence of COVID-19. Pollen and AREDVs peak earlier in the spring and are more strongly interconnected, while asthma rates among children are rapidly rising, particularly in the fall and winter. These findings can advise targeted awareness campaigns for better management of asthma related morbidity.

本研究旨在分析美国布朗克斯区成人与儿童群体的花粉浓度与哮喘相关急诊就诊量（asthma-related emergency department visits, AREDV）的长期变化趋势。研究回溯获取了2001年至2020年间布朗克斯区3家主要医院的成人与儿童AREDV日度数据，数据提取采用国际疾病分类第十次修订版（ICD-10）编码；同期花粉浓度数据则来自阿蒙克监测站点。本研究采用威尔科克森秩和检验（Wilcoxon Ranked Sum）比较中位数水平，并通过斯皮尔曼相关性分析（Spearman correlation）探究两个十年周期及各季节内两类变量间的关联。2001-2010年（第一个十年）至2011-2020年（第二个十年）期间，儿童AREDV中位数水平增长200%（P<0.001）；且AREDV的峰值时段从第一个十年的春季为主，转变为第二个十年的秋、冬季为主。20年间的季节分布模式保持稳定：夏季AREDV水平显著低于其他所有季节（日均9 vs. 17，P<0.001）。春季树木花粉浓度峰值与AREDV峰值呈显著相关（rho=0.34，P<0.001）。当树木花粉浓度超过100粒/立方米时，AREDV中位数为19.0；而当树木花粉浓度处于0-99粒/立方米区间时，AREDV中位数为15.0（P<0.001）。2020年AREDV出现大幅下降，与新冠疫情（COVID-19）的暴发时间重合。春季花粉与AREDV的峰值出现时间更早，且二者关联强度更高；同时儿童哮喘患病率正快速上升，这一趋势在秋、冬季尤为显著。本研究结果可为针对性的健康宣教活动提供参考，助力优化哮喘相关疾病负担的管理策略。