Hospital admissions for asthma and acute bronchitis in El Paso, Texas: Do age, sex, and insurance status modify the effects of dust and low wind events?

Abstract

Background El Paso County (Texas) is prone to still air inversions and is one of the dust “hot spots” in North America. In this context, we examined the sub-lethal effects of airborne dust and low wind events on human respiratory health (i.e., asthma and acute bronchitis) between 2000 and 2003, when 110 dust and 157 low wind events occurred. Because environmental conditions may not affect everyone the same, we explored the effects of dust and low wind within three age groups (children, adults, and the elderly), testing for effect modifications by sex and insurance status, while controlling for weather and air pollutants. Methods We used a case-crossover design using events matched with referent days on the same day-of-the-week, month, and year with conditional logistic regression to estimate the probability of hospital admission, while controlling for apparent temperature (lag 1), nitrogen dioxide, and particulate matter of 2.5 micrometers or less. Results Children (aged 1–17) were 1.19 (95% confidence interval: 1.00–1.41) times more likely to be hospitalized for asthma three days after a low wind event, and 1.33 (95% CI: 1.01–1.75) times more likely to be hospitalized for acute bronchitis one day after a dust event than on a clear day. Girls were more sensitive to acute bronchitis hospitalizations after dust events (1.83, 95% CI: 1.09–3.08) than boys, but less sensitive than boys to acute bronchitis hospitalizations after low wind events (0.68, 95% CI: 0.46–1.00). We found general trends with regard to dust and low wind events being associated with increased odds of hospitalization for asthma and bronchitis amongst all ages and adults (aged 18–64). Adults covered by Medicaid and adults without health insurance had higher risks of hospitalization for asthma and acute bronchitis after both low wind and dust event Conclusions Results suggest that there were respiratory health effects associated with dust and low wind events in El Paso, with stronger impacts among children and poor adults. Girls and boys with acute bronchitis were differentially sensitive to dust and low wind events.

Intensified dust storm activity and Valley fever infection in the southwestern United States

“…Beyond increases in airborne particulate matter concentrations but short of the extreme of another Dust Bowl [ Lee and Gill , 2015; Sterk et al ., 2016], dust storms in the Southwest are known to be linked with numerous environmental impacts, including other respiratory diseases such as asthma and bronchitis [ Grineski et al ., 2011; Rodopoulou et al ., 2014], highway safety [ Hyers and Marcus , 1981], loss of efficiency of solar energy generation systems [ Sinha et al ., 2014], increased mountain snowmelt [ Skiles et al ., 2015; Clow et al ., 2016], changes to alpine ecosystems [ Steltzer et al ., 2009], loss of soil fertility/nutrients/carbon [ Alvarez et al ., 2012], and breakdown of soil structure [ Belnap and Gillette , 1998]. Thus, signs of an increase in dust storm activity also serve as warnings that numerous other environmental hazards will surely increase and act as a call for careful management and attention to these hazards.…”

“…Exposure to dust particles has been associated with various detrimental effects on human health [e.g., Chen et al ., 2004; Perez et al ., 2008; Grineski et al ., 2011; Rodopoulou et al ., 2014]. The U.S. Centers for Disease Control and Prevention ( CDC ) [2013] reports a sharp increase of coccidioidomycosis incidences from 1998 to 2011 in the same regions where dust storms have increased.…”

A Systematic Review of Global Desert Dust and Associated Human Health Effects

“…In Athens, Greece, Saharan dust events have been associated with a 2.54% increase of pediatric asthma hospital admissions based on a 10 µg/m 3 increase in PM 10 [79]. People of all ages in El Paso of Texas were 1.11 times more likely to be hospitalized by asthma on a dust event day than on a clear day [80]. Bell et al [81] investigated the relationship between cause-specific hospital admissions and sandstorms in Taipei, and that found asthma admissions rose 4.48% per 28 µg/m 3 increase in PM 10 levels.…”

Effects of Long-Term Dust Exposure on Human Respiratory System Health in Minqin County, China

“…23 In additions, a study showed that females were more sensitive to acute bronchitis after dust events than males. 24 Age is an independent factor associated with chronic bronchitis. A higher prevalence was observed in older people, 13 which is similar to our results (Table 4).…”