<p>Extreme desert dust storms and COPD morbidity on the island of Crete</p>

Abstract

Introduction and objectives Short-term extreme increases in desert-derived particulate-matter with aerodynamic diameter below 10 μm (PM 10 ) may affect emergency department (ED) visits due to COPD exacerbations. Research question Our aim was to identify the effect of extreme increases in desert-derived PM 10 on ED visits for dyspnea and COPD exacerbations and on the related hospital admissions. Methods We performed a retrospective analysis of dyspnea-related ED visits and hospital admissions in Heraklion, Crete, during four consecutive storms of desert-derived PM 10 that happened during March 2018. We collected data from over 17,000 ED visits and recorded patients with atopic symptoms, COPD exacerbations, and dyspnea, as well as admissions to the departments of pulmonary medicine, internal medicine, and cardiology. PM 10 data were collected from a monitoring station in the same geographic area. Results Four desert dust storms were recorded during the study period with 238, 203, 1138, and 310 μg/m 3 average-daily PM 10 and 652, 308, 4262, and 778 μg/m 3 hourly mean day-peak PM 10, respectively. There was no clinically important increase in total ED visits, total admissions or admissions to the departments of cardiology, pulmonary medicine, or internal medicine, during PM 10 peaks. However, during the desert dust storm with daily-average PM 10 above 500 μg/m 3 , there was a striking increase in dyspnea-related ED visits (including COPD exacerbations, 3.6-fold increase), while there was no clinically important increase in non-asthma allergy-related ED visits. Conclusion Extreme desert dust storm episodes may cause meaningful increases in ED visits for dyspnea and COPD exacerbations/admissions.

Respiratory symptoms, lung function, and fraction of exhaled nitric oxide before and after assignment in a desert environment—a cohort study

“…The primary findings of this study are that exposure to a desert storm was associated with a decrease in FEV 1 after exposure. Several previous studies have reported increased respiratory symptoms after exposure to desert storms [8][9][10][11][12][13][14][15][16][17], but to our knowledge, objective measures of particulate matters and effects on the lungs both before and after exposure have not been examined previously.…”

“…Several studies have reported respiratory symptoms and conditions among military personnel after service in countries with recurrent desert storms, suggesting that exposure to different small particles during desert storms could contribute to the development of respiratory disease [8][9][10][11][12][13][14]. A number of studies have also reported that increased respiratory hospitalisations in European countries such as Italy, Greece and Cyprus are associated with temporary dust spreading from desert storms originating in Sahara [15][16][17].…”

Association between African Dust Transport and Acute Exacerbations of COPD in Miami

“…A study conducted in Taiwan showed a 20% increase in COPD-related hospital admissions in response to dust exposure [ 40 ]. A recent study also documents a 3.6-fold increase in COPD exacerbations with the increase in PM 10 during four dust storms [ 41 ].…”

Global Health Impacts of Dust Storms: A Systematic Review

“…Regarding respiratory diseases related to dust storms, 35 studies stated that dust storms can increase the risk of respiratory outpatients, 91 respiratory disease hospitalizations or admissions, 11 , 40 , 43 , 51 , 57 , 78 , 92 , 93 , 96 , 104 , 106 - 114 cases of bronchial asthma, 93 asthma-related hospitalizations or admissions, 51 , 57 , 112 - 116 cases of aggravated asthma disease, 117 , 118 daily pneumonia admissions, 119 , 120 hospital admissions for chronic obstructive pulmonary disease (COPD), 50 , 87 , 121 - 123 emergency hospital admissions for COPD, 124 emergency admissions for respiratory diseases, 92 admitted patients suffering from respiratory infection, 50 and the prevalence of chronic bronchitis, cough, and rhinitis. 125 …”