The 2016 Melbourne thunderstorm asthma epidemic: Risk factors for severe attacks requiring hospital admission

Hew, Mark; Lee, Joy; Susanto, Nugroho Harry; Prasad, S.; 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; Conron, Matthew; Matthews, Sarah; Harun, Nur-Shirin; Lachapelle, Philippe; Douglass, Jo A; Irving, Louis; Langton, David; Mann, Jason R.; Erbas, Bircan; Thien, Francis

doi:10.1111/all.13609

Cited by 62 publications

(96 citation statements)

References 41 publications

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“…Similar to previous reports, younger age and being born in an Asian country, were also found to be risk factors, while smoking was not found to be a risk factor . Hayfever prevalence is significantly greater in Asian‐born immigrants compared to non‐Asian‐born Australians and increases with the length of stay in Australia .…”

Section: Discussionsupporting

confidence: 86%

“…Hayfever prevalence is significantly greater in Asian‐born immigrants compared to non‐Asian‐born Australians and increases with the length of stay in Australia . Such a high prevalence of hayfever potentially confers an increased risk for TA …”

Section: Discussionmentioning

confidence: 99%

“…Based on previous work, a small number of factors were examined in a multivariable logistic regression with control versus TA16 as the outcome variable and the following as independent variables: age (found by preliminary graphic analysis to be approximately linearly related), gender, born in Asia, past history asthma, past history hayfever, beta‐blocker and aspirin or NSAIDs use. Aspirin and NSAIDs use were combined for analysis due to their low frequencies.…”

Section: Methodsmentioning

confidence: 99%

“…A general belief is that during pollen season, thunderstorms can significantly increase the levels of airborne pollen, by wind/plume action on ground level pollen, and through osmotic effect, break up pollens into particles, which are small enough to bypass the nasal passages and enter the lungs directly, triggering asthma . Recent studies of TA16 identified hayfever, asthma, younger age and Asian country of birth as risk factors for TA cases presenting to hospital . The focus of previous TA studies has been of the aetiological link between pollen exposure, hayfever, pre‐existing asthma and TA .…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies of TA16 identified hayfever, asthma, younger age and Asian country of birth as risk factors for TA cases presenting to hospital . The focus of previous TA studies has been of the aetiological link between pollen exposure, hayfever, pre‐existing asthma and TA . Smoking has been studied and shown not to be a risk factor for TA .…”

Section: Introductionmentioning

confidence: 99%

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Beta‐blocker use is an independent risk factor for thunderstorm asthma

Sultana

McKenzie

Fahey

et al. 2019

Emerg Medicine Australasia

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Objective: To identify risk factors for thunderstorm asthma (TA) in subjects ≥15 years of age from information available in routine clinical records. Methods: Retrospective and hospital-based case-control study of various clinical factors in all TA cases (n = 53) who presented to a single-site ED in November 2016 (TA16) and in a control group of patients (n = 156) who presented to the same ED with asthma during the pollen season over eight non-TA years. Bivariate analysis and multivariable logistic regression modelling was performed to calculate the odds of TA asthma in the presence of potential risk factors. Results: A logistic regression model revealed that the odds of TA were lower for age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.95-0.99), higher for Asian country of birth (OR 4.09, 95% CI 1.40-11.95) and higher for oral beta-blocker use (OR 6.43, 95% CI 1.58-26.33) compared to controls. No difference was found between TA16 cases and controls for allergies (to medication, grass pollen, animal), hayfever, smoking, oral non-steroidal anti-inflammatory drugs, or aspirin. Newly diagnosed asthma was higher in TA16 cases versus controls (32.1% vs 12.2%, P = 0.001). Conclusions:Oral beta-blocker medications, younger age and Asianborn heritage are risk factors for TA. Further study is required to explore the potential association between beta-blockers and TA. Key findings• Oral beta-blockers, age, Asianborn heritage are independent risk factors for thunderstorm asthma. • Non-steroidal anti-inflammatory drugs and aspirin are not risk factors for thunderstorm asthma.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Beta‐blocker use is an independent risk factor for thunderstorm asthma

Sultana

McKenzie

Fahey

et al. 2019

Emerg Medicine Australasia

Self Cite

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Characterising the allergic profile of children with cystic fibrosis

Faulkner

Grayling

Shillitoe

et al. 2021

Immunity Inflam & Disease

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Background: Cystic fibrosis (CF) is a genetic condition that affects multiple organ systems. Allergic bronchopulmonary aspergillosis (ABPA) is a wellrecognised problem but other allergic conditions are less well documented in CF.Objective: To characterise the allergic profile of a cohort of children with CF, with a focus on those with ABPA.Methods: A cohort of children with CF were interviewed and retrospective data were collected regarding their allergic histories and other relevant clinical features. Results:The cohort included 37 children with median age of 9 years (interquartile range: 6-12). There was a history of ≥1 allergic condition(s) in 28/37 children (76%). The most common allergic condition was allergic rhinitis (AR) in 21/37 (57%) and 16 of these 21 children (76%) had another allergic condition. All children with ABPA (8) had another allergic condition. In some children ABPA exacerbations appeared to be seasonal, suggesting possible cross-sensitisation between Aspergillus fumigatus and aeroallergens associated with seasonal AR. Allergic conditions were also common in children with Pseudomonas aeruginosa infection.

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