BACKGROUND: The world's most catastrophic and deadly thunderstorm asthma epidemic struck Melbourne, Australia, on November 21, 2016. OBJECTIVE: Among thunderstorm-affected patients presenting to emergency rooms (ERs), we investigated risk factors predicting severe attacks requiring admission to hospital. METHODS: Thunderstorm-affected patients were identified from ER records at the eight major Melbourne health services and interviewed by telephone. Risk factors for hospital admission were analyzed. RESULTS: We interviewed 1435/2248 (64%) of thunderstorm-affected patients, of whom 164 (11.4%) required hospital admission. Overall, rhinitis was present in 87%, and current asthma was present in 28%. Odds for hospital admission were higher with increasing age (odds ratio 1.010, 95% CI 1.002, 1.019) and among individuals with current asthma (adjusted odds ratio [aOR] 1.87, 95% CI 1.26, 2.78). Prior hospitalization for asthma in the previous 12 months further increased the odds for hospital admission (aOR 3.16, 95% CI 1.63, 6.12). Among patients of Asian ethnicity, the odds for hospital admission were lower than for non-Asian patients (aOR 0.59, 95% CI 0.38, 0.94), but higher if born in Australia (OR = 5.42, 95% CI 1.56, 18.83). CONCLUSIONS: In epidemic thunderstorm asthma patients who presented to the ER, higher odds for hospital admission among patients with known asthma were further amplified by recent asthma admission, highlighting the vulnerability conferred by suboptimal disease control. Odds for hospital admission were lower in Asian patients born overseas, but higher in Asian patients born locally, than in non-Asian patients; these observations suggest susceptibility to severe thunderstorm asthma may be enhanced by gene-environment interactions.
BACKGROUND: The world's most catastrophic and deadly thunderstorm asthma epidemic struck Melbourne, Australia, on November 21, 2016. OBJECTIVE: Among thunderstorm-affected patients presenting to emergency rooms (ERs), we investigated risk factors predicting severe attacks requiring admission to hospital. METHODS: Thunderstorm-affected patients were identified from ER records at the eight major Melbourne health services and interviewed by telephone. Risk factors for hospital admission were analyzed. RESULTS: We interviewed 1435/2248 (64%) of thunderstorm-affected patients, of whom 164 (11.4%) required hospital admission. Overall, rhinitis was present in 87%, and current asthma was present in 28%. Odds for hospital admission were higher with increasing age (odds ratio 1.010, 95% CI 1.002, 1.019) and among individuals with current asthma (adjusted odds ratio [aOR] 1.87, 95% CI 1.26, 2.78). Prior hospitalization for asthma in the previous 12 months further increased the odds for hospital admission (aOR 3.16, 95% CI 1.63, 6.12). Among patients of Asian ethnicity, the odds for hospital admission were lower than for non-Asian patients (aOR 0.59, 95% CI 0.38, 0.94), but higher if born in Australia (OR = 5.42, 95% CI 1.56, 18.83). CONCLUSIONS: In epidemic thunderstorm asthmapatients who presented to the ER, higher odds for hospital admission among patients with known asthma were further amplified by recent asthma admission, highlighting the vulnerability conferred by suboptimal disease control. Odds for hospital admission were lower in Asian patients born overseas, but higher in Asian patients born locally, than in non-Asian patients; these observations suggest susceptibility to severe thunderstorm asthma may be enhanced by gene-environment interactions.
Authors: Nur Sabrina Idrose; Caroline J Lodge; Bircan Erbas; Jo A Douglass; Dinh S Bui; Shyamali C Dharmage Journal: Int J Environ Res Public Health Date: 2022-06-20 Impact factor: 4.614
Authors: Chuan T Foo; Sonali Fernando; Naomi Cohen; Golsa Adabi; Cheryl M T Lim; Alan C Young; Francis Thien Journal: Asia Pac Allergy Date: 2020-07-21
Authors: Milena Sokolowska; Valerie F J Quesniaux; Cezmi A Akdis; Kian Fan Chung; Bernhard Ryffel; Dieudonnée Togbe Journal: Front Immunol Date: 2019-09-13 Impact factor: 7.561
Authors: Chuan T Foo; Ellen Ly Yee; Alan Young; Eve Denton; Mark Hew; Robyn E O'Hehir; Naghmeh Radhakrishna; Sarah Matthews; Matthew Conron; Nur-Shirin Harun; Philippe Lachapelle; Jo Anne Douglass; Louis Irving; Joy Lee; Wendy Stevenson; Christine F McDonald; David Langton; Ceri Banks; Francis Thien Journal: Asia Pac Allergy Date: 2019-10-17
Authors: Mark Hew; Joy Lee; Nirupama Varese; Pei M Aui; Craig I McKenzie; Bruce D Wines; Heather Aumann; Jennifer M Rolland; Phillip Mark Hogarth; Menno C van Zelm; Robyn E O'Hehir Journal: Allergy Date: 2020-05-04 Impact factor: 13.146