Patterns of asthma exacerbation related to climate and weather in the Northeast Kingdom of Vermont.

摘要

Asthma is a chronic respiratory disease characterized by long- and short-term inflammation and bronchospasm susceptible to multiple triggers that affects patients across the lifespan. Asthma management is a primary care priority in Vermont, where there continues to be an above-average prevalence of asthma among both children and adults as compared to other states. However, many of Vermont's children and especially adults with asthma are not participating in regular check-ups for asthma management that would best prevent exacerbation of asthma symptoms. Several climate and weather elements including, but not limited to, extreme temperatures and particulate matter are known asthma triggers. Vermont's high per capita use of old woodstoves, pockets of poverty and cold winters are all factors that might collide to adversely impact residents' asthma. Insights into how climate and weather might be related to peak periods of acute asthma exacerbation (AAE) among individuals living in the rural Northeast Kingdom of Vermont (NEK) could provide valuable, regionally focused public health information to primary care providers on the front lines of asthma management.;The objective of this research was to examine the potential relationship between the climate and weather of the NEK and visits for asthma exacerbation in the primary care setting. The research began with a retrospective chart review including visits to five different clinic sites in the NEK between 2009-2014 with the ICD-9 code for asthma exacerbation (493.xx) as the primary diagnosis. When visits were individually validated as an AAE, the clinic site, date of visit, and the patients' age and sex were documented. These validated visits were then analyzed against weather and climate data including temperature and air quality. Results suggest that while diurnal shifts and air quality do not show a strong relationship with AAEs in this area, colder days do appear to correlate to when patients visit primary care clinics in the NEK for AAEs.