BACKGROUND Quantifying the effects of personal health behaviors and environmental exposure on asthma flare-ups is a challenge. Most studies have focused on monitoring the symptoms and drug usage for relieving symptoms. In this study, we emphasize the need to understand how personal and environmental conditions are related to the occurrence of asthma symptoms. METHODS We designed an online health diary platform to collect personal health behaviors from children, their parents and other adults with any allergic diseases including asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis. The participants used mobile devices or computers to record their daily health-related activities such as sleep, exercise, diet, perception of air quality and temperature, and asthma symptoms. The participants also recorded secondhand smoke exposure and the time of activities, which were combined with ambient air quality measurements for calculating personal air pollution exposure. A generalized linear mixed model was used to estimate the effects of the factors. RESULTS During the study period (January 2017-June 2017, and October 2017-September 2018), 132 participants provided 25,016 diary entries, and 84 participants had experienced asthma symptoms in 1458 diary entries. The results showed some different risk factors for the minors and adults. For minors, high-intensity exercise, contact with persons with influenza-like illness (ILI) and the perception of hot temperature and bad indoor air quality were associated with the occurrence of asthma episodes. The identified risk factors for the adult participants included having dehumidifiers at home, exposure to secondhand smoke, having bad sleep quality, contact with persons with ILI, not eating fruit and seafood, perceiving cold temperature, bad quality of indoor and outdoor air, and exposure to high concentration of ozone. CONCLUSIONS The revealed personal risk factors and perceptions of air quality and temperature may provide guidance on behavioral change for people susceptible to asthma to help control acute onset and severe exacerbation of asthma flare-ups.

中文翻译：

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评估个人行为和环境暴露对哮喘发作的影响：一种基于日记的方法。

背景技术量化个人健康行为和环境暴露对哮喘发作的影响是一个挑战。大多数研究都集中在监控症状和减轻症状的药物使用上。在这项研究中，我们强调需要了解个人和环境条件与哮喘症状发生之间的关系。方法我们设计了一个在线健康日记平台，以收集儿童，父母和其他成年人的个人健康行为，包括哮喘，过敏性鼻炎，特应性皮炎和过敏性结膜炎等任何过敏性疾病。参与者使用移动设备或计算机记录他们日常与健康有关的活动，例如睡眠，运动，饮食，对空气质量和温度的感知以及哮喘症状。参与者还记录了二手烟暴露和活动时间，并结合了周围空气质量测量结果来计算个人空气污染暴露。使用广义线性混合模型来估计因素的影响。结果在研究期间（2017年1月至2017年6月以及2017年10月至2018年9月），有132名参与者提供了25016项日记条目，其中84名参与者在1458项日记中出现了哮喘症状。结果表明，未成年人和成年人有一些不同的危险因素。对于未成年人，高强度运动，与患有流感样疾病（ILI）的人接触以及对高温和室内空气质量差的认识与哮喘发作的发生有关。对于成年参与者，已确定的危险因素包括在家中有除湿机，接触二手烟，睡眠质量差，与ILI人员接触，不吃水果和海鲜，感知低温，室内和室外空气质量差以及暴露到高浓度的臭氧。结论揭示的个人危险因素以及对空气质量和温度的感知可能为易感哮喘的人的行为改变提供指导，以帮助控制哮喘发作的急性发作和严重加重。