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Title: The 2016 Melbourne thunderstorm asthma epidemic: risk factors for severe attacks requiring hospital admission.
Austin Authors: Hew, Mark;Lee, Joy ;Susanto, Nugroho H;Prasad, Shivonne;Bardin, Philip G;Barnes, Sara;Ruane, Laurence;Southcott, Anne Marie;Gillman, Andrew;Young, Alan;Rangamuwa, Kanishka;O'Hehir, Robyn E;McDonald, Christine F ;Sutherland, Michael F;Conron, Matthew;Matthews, Sarah;Harun, Nur-Shirin;Lachapelle, Philippe;Douglass, Jo A;Irving, Louis;Langton, David;Mann, Jennifer;Erbas, Bircan;Thien, Francis
Affiliation: Peninsula Health. Melbourne, Victoria, Australia
Monash Health, Melbourne, Victoria, Australia
Western Health, Melbourne, Victoria, Australia
Austin Health
Melbourne Health, Melbourne, Victoria, Australia
Melbourne University, Melbourne, Victoria, Australia
St Vincent's Health, Melbourne, Victoria, Australia
Alfred Health, Melbourne, Victoria, Australia
Monash University, Melbourne, Victoria, Australia
La Trobe University, Melbourne, Victoria, Australia
Eastern Health, Melbourne, Victoria, Australia
Issue Date: 2019
Date: 2018-09-22
Publication information: Allergy 2019; 74(1): 122-130
Abstract: The world's most catastrophic and deadly thunderstorm asthma epidemic struck Melbourne, Australia, on November 21st 2016. Among thunderstorm-affected patients presenting to emergency rooms (ERs), we investigated risk factors predicting severe attacks requiring admission to hospital. 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. 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 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). 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. This article is protected by copyright. All rights reserved.
DOI: 10.1111/all.13609
ORCID: 0000-0002-7498-0000
Journal: Allergy
PubMed URL: 30243030
Type: Journal Article
Subjects: Asian
Appears in Collections:Journal articles

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