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There has been significant interest in recent years on the effect of the environment on respiratory health and fairly consistent evidence that air pollution and temperature are somehow associated with asthma symptoms. However, studies have varied in the relationships found, with some suggesting high and others low temperature associations with asthma morbidity.1–3 Several air pollutants, such as particulate matter, NO2 and O3, have been inconsistently associated with asthma and inevitably temperature confounds associations between asthma and pollutants.2 ,4 In addition, ambient temperature, particularly in temperate climates, may affect dry powder inhaler drug stability, and this may inadvertently confound worsening asthma control in areas of high humidity and high temperature, such as Hong Kong.5 ,6
So while assessing the liaison between meteorological factors and asthma hospitalisations is not new, few studies have had sufficient statistical power to differentiate the effect of exposures on differing populations; that is children, adults and the elderly in a subtropical climate and in a city such as Hong Kong. With climate change an evolving phenomenon that will not go away, and increasing interest in disease ‘splitting’ as opposed …
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