Turkiye Klinikleri Journal of Biostatistics

.: ORIGINAL RESEARCH
A Spatial Analysis of Air Quality and Food Consumption Surrogates in Relation to Asthma Deaths: An Analytical Research
Hava Kalite ve Gıda Tüketim Belirteçlerinin Astıma Bağlı Ölümlerin İlişkisinin Mekânsal Bir Analizi: Analitik Bir Araştırma
Begüm TÜZÜNERa, Mahmut MERGENb, Selman AKTAŞc,d, Mehmet KOÇAKb,e
aDepartment of Industrial Engineering, Boğaziçi University Faculty of Engineering, İstanbul, Türkiye
bDepartment of Biostatistics, İstanbul Medipol University International Faculty of Medicine, İstanbul, Türkiye
cDepartment of Biostatistics, University of Health Sciences Faculty of Medicine, İstanbul, Türkiye
dDepartment of Biostatistics, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
eDepartment of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
Turkiye Klinikleri J Biostat. 2022;14(1):1-13
doi: 10.5336/biostatic.2021-84929
Article Language: EN
Full Text
ABSTRACT
 Objective: Asthma is among the most common diseases affecting more than 300 million people globally overall. Despite growing understanding of the association between the environmental and food intake markers and the etiology and progression of asthma, there is still unmet knowledge gap which requires further investigations to be done in a spatial and temporal manner. We carried out such a study to explore the association of air-quality markers, fruit and vegetable consumption and drinking water source trajectories with asthma death rate in spatial models. Material and Methods: Province-level data on asthma deaths, air-quality markers, namely, particular matter 10 and 2.5, sulfur-dioxide, carbon monoxide (CO), nitrogen-dioxide, and ozone, drinking water source data from rivers, dams, wells, and springs as well as fruits and vegetables sales data were obtained for 81 provinces of Turkey for years 2018 and 2019. Mixed modelling approach taking into consideration the spatial autocorrelation was used to investigate the associations of these environmental and food consumption variables with asthma deaths. Results: These models revealed decreased asthma deaths with increased consumption of apple, banana, cabbage, lemon, onion, pineapple, spinach and zucchini, and increased asthma deaths with increased CO concentration and increased broad bean consumption. Conclusion: As a conclusion, we showed that spatial and temporal analyses have premise to offer much needed information to help close the knowledge gap in understanding the association of environmental and food intake markers with asthma deaths in granular spatial models. We have also showed that such efforts are possible by extracting publicly available data as well.

Keywords: Asthma deaths; air quality markers; drinking water sources; fruit consumption; vegetable consumption
ÖZET
 Amaç: Astım, tüm dünyada 300 milyondan fazla insanı etkileyen en yaygın hastalıklar arasındadır. Çevresel belirteçler ve gıda tüketim belirteçleri ile astımın etiyolojisi ve ilerlemesi arasındaki ilişkiye dair artan bilgiye rağmen hâlâ mekânsal ve zamansal daha fazla araştırmanın yapılmasını gerektiren doldurulamamış bir bilgi boşluğu bulunmaktadır. Biz de hava kalitesi belirteçleri, meyve ve sebze tüketimi ve içme suyu kaynakları ile astım ölüm oranı arasındaki ilişkiyi mekânsal modellemeler kullanarak incelemek amacıyla böyle bir çalışma yürüttük. Gereç ve Yöntemler: İl düzeyinde astım ölümleri, hava kalitesi belirteçleri yani partikül maddesi 10 ve 2,5, kükürtdioksit, karbonmonoksit (CO), nitrojen dioksit ve ozon; nehirlerden, barajlardan, kuyulardan ve kaynaklardan sağlanan içme suyu miktarları ile Türkiye'nin 81 ilinden 2018 ve 2019 yıllarına ait meyve-sebze satış verileri elde edilmiştir. Mekânsal otokorelasyonu dikkate alan karma modelleme yaklaşımı (MIXED models), astım ölümlerinin çevresel ve gıda tüketim değişkenleri ile ilişkisini araştırmak için kullanılmıştır. Bulgular: Bu modeller; elma, muz, lahana, limon, soğan, ananas, ıspanak ve kabak tüketiminde artışla birlikte azalan astım ölümlerini ve CO konsantrasyonu ve bakla tüketimi ile artan astım ölümlerini ortaya çıkarmıştır. Sonuç: Sonuç olarak mekânsal ve zamansal analizlerin, çevresel faktörler ve gıda tüketimi değişkenleri ile astıma dayalı ölümler arasındaki ilişkiyi anlamadaki bilgi boşluğunu kapamadaki faydasını gösterdik. Bunun yanı sıra bu tür çabaların, kamuya açık verilerin çıkarılmasıyla mümkün olduğunu da ortaya koyduk.

Anahtar Kelimeler: Astım ölümleri; hava kalitesi belirteçleri; içme suyu kaynakları; meyve tüketimi; sebze tüketimi
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