Abstract
BackgroundThe Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO2). The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area.MethodsRespiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO2 concentration and high SO2 levels (24-h mean SO2 > 125 μg/m3) were analysed using generalized additive models.ResultsAfter the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39–1.58%) per 10 μg/m3 at lag 0–2, in PCMD for respiratory causes 1.26% (95% CI 0.72–1.80%) per 10 μg/m3 SO2 at lag 0–2, and in HED by 1.02% (95% CI 0.02–2.03%) per 10 μg/m3 SO2 at lag 0–2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1–19.6%), 17.2% (95% CI 10.0–24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49–1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54–1.71%) and 2.08% (1.13–3.04%).ConclusionHigh levels of volcanic SO2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible.
Highlights
SO2 (Sulphur dioxide) exposure is associated with respiratory health morbidity and mortality [1, 2] and at higher concentrations (a 10 min mean over 500 μg SO2 per m3) it is associated with irritation of the respiratory tract in susceptible individuals [2] and can trigger respiratory symptoms such as acute bronchial asthma, pulmonary oedema, and respiratory distress [3] – especially in individuals with hyper-reactivity syndrome [4]
In hospital emergency department visits (HED), 17.5 individuals attended for respiratory disease, the individuals had a mean age of 39.4 years (SD 30.5) and 51.8% were women (Table 2)
Restricting this analysis to only the time of the year where the eruption was ongoing we found that asthma medication dispensing (AMD) was significantly increased 138.2 vs 158.4, p = 0.0035)
Summary
SO2 (Sulphur dioxide) exposure is associated with respiratory health morbidity and mortality [1, 2] and at higher concentrations (a 10 min mean over 500 μg SO2 per m3) it is associated with irritation of the respiratory tract in susceptible individuals [2] and can trigger respiratory symptoms such as acute bronchial asthma, pulmonary oedema, and respiratory distress [3] – especially in individuals with hyper-reactivity syndrome [4]. During the Holuhraun volcanic eruption in the Barðarbunga central volcanic system SO2 was dispersed widely over Iceland according to meteorological conditions [7], reaching the capital area some 250 km from the eruption site where the 24-h air quality guideline limit for SO2, 125 μg/m3 [2], was exceeded repeatedly during the fall of 2014. The Barðarbunga volcanic system is located in the central highlands of Iceland which is uninhabited and no humans live within 50 km of the eruption site so there was no immediate danger, several steps were taken to inform and advise the public of the situation with the dispersed SO2 gas. The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area
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