Abstract
Background:Studies have shown a positive association between air pollutants and asthma in children. The Negev desert (Israel) is frequently subjected to dust storms (DS) originating from arid soils. The evidence regarding the association with non-anthropogenic PM due to DS is limited. Aims:To assess the impact of DS on asthma/wheezing hospitalizations and asthma medications utilization. Methods:We identified children admitted to Soroka University Medical Center (SUMC, serving a population of 261,600 children in Negev) during 2001-2011 with asthma or wheezing. Meteorological and air-pollution data were obtained. An air-polluted day was defined as a day with a PM10 concentration two standard deviations above the background. We used a case crossover analysis with conditional logistic regression for hospitalizations and time series analysis (GLM and GAM models) for asthma medications purchase assessments. Results:3,481 children were admitted (5,304 hospitalizations), 62% were males and 52.5% under two years. The average admissions number was 1.04/day, with higher incidence during the winter season (1.5/day). The number of DS days was 461 (12%). DS increased the risk for the same day hospitalization by 1.09 (95%CI 0.99-1.20, P=0.08), adjusted for seasonality, temperature, relative humidity and SO2. Exclusion of children with respiratory infections did not change the inference. In the spring-summer the association was stronger (odds ratio [OR]=1.43, 95%CI 1.42-1.72, P=0.01). In analysis by ethnicity, the positive significant effect was shown only among Bedouin Arabs (OR=1.93, 95%CI 1.04-1.35, P=0.008). Asthma medications purchase was 15% higher in DS days (95%CI 17-23%, P<0.01). Conclusion:The high PM10 levels during DS days increase the risk for asthma hospitalizations and purchasing of asthma medications among children, mostly in the spring and summer seasons. Bedouin children are at greater risk, partially due to residing in non-permanent dwelling conditions.
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