Health risk of air pollution on people living with major chronic diseases: a Canadian population-based study

Abstract

ObjectivesThe objective of this study was to use health administrative and environmental data to quantify the effects of ambient air pollution on health service use among those with chronic diseases. We hypothesised that health service use would be higher among those with more exposure to air pollution as measured by the Air Quality Health Index (AQHI).SettingHealth administrative data was used to quantify health service use at the primary (physician office visits) and secondary (emergency department visits, hospitalisations) level of care in Ontario, Canada.ParticipantsWe included individuals who resided in Ontario, Canada, from 2003 to 2010, who were ever diagnosed with one of 11 major chronic diseases.Outcome measuresRate ratios (RR) from Poisson regression models were used to estimate the short-term impact of incremental unit increases in AQHI, nitrogen dioxide (NO2; 10 ppb), fine particulate matter (PM2.5; 10 µg/m3) and ozone (O3; 10 ppb) on health services use among individuals with each disease. We adjusted for age, sex, day of the week, temperature, season, year, socioeconomic status and region of residence.ResultsIncreases in outpatient visits ranged from 1% to 5% for every unit increase in the 10-point AQHI scale, corresponding to an increase of about 15 000 outpatient visits on a day with poor versus good air quality. The greatest increases in outpatient visits were for individuals with non-lung cancers (AQHI:RR=1.05; NO2:RR=1.14; p<0.0001) and COPD (AQHI:RR=1.05; NO2:RR=1.12; p<0.0001) and in hospitalisations, for individuals with diabetes (AQHI:RR=1.04; NO2:RR=1.07; p<0.0001) and COPD (AQHI:RR=1.03; NO2:RR=1.09; p<1.001). The impact remained 2 days after peak AQHI levels.ConclusionsAmong individuals with chronic diseases, health service use increased with higher levels of exposure to air pollution, as measured by the AQHI. Future research would do well to measure the utility of targeted air quality advisories based on the AQHI to reduce associated health service use.

The San Diego 2007 wildfires and Medi-Cal emergency department presentations, inpatient hospitalizations, and outpatient visits: An observational study of smoke exposure periods and a bidirectional case-crossover analysis

“…However, the nature and intensity of health impacts are expected to depend on characteristics of the receptor population [ 16 , 17 , 21 ]. Research on vulnerability to ambient air pollution has identified subpopulations with increased susceptibility to the effects of PM; these include persons with chronic diseases [ 22 ], as well as older adults, children, and possibly those with lower education, income, and employment status [ 23 ]. Although PM of wildfire origin differs from ambient air pollution in composition and exposure patterns, current research suggests that elderly and young populations will also be especially vulnerable to wildfire-derived PM [ 16 , 17 , 24 ].…”

Human lung and monocyte-derived macrophages differ with regard to the effects of β2-adrenoceptor agonists on cytokine release

“…Air pollution is also associated with the acute worsening of pre-existing asthma and chronic obstructive pulmonary disease (COPD) and with progression from asthma to COPD [4, 5]. …”

Effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with chronic respiratory disease in Ulaanbaatar: pilot study for the comparison of the cold and warm seasons

“…Tseng et al ( 2013 ) demonstrated the effect of cold temperatures on the exacerbation of COPD, and Alahmari et al ( 2015 ) reported that high level of atmospheric pollution had independent effects on the physical activity of COPD patients. Air pollution also increased the incidence of outpatient visits due to COPD even after standardization of temperature (To et al 2015 ). These reports also suggested that air pollution had independent health impact on COPD and BA patients besides temperature.…”