Abstract
Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.
Highlights
Respiratory diseases are one of the leading causes of both morbidity and mortality worldwide [1,2].Lung infections, chronic obstructive pulmonary diseases (COPD), asthma, and lung cancer are main contributors of both respiratory-related mortality and morbidity [3]
The daily mean of PM10 levels were highest in Landskrona (19.5 μg/m3 ), whereas the daily mean for the whole study area was (17.39 μg/m3 )
The number of primary health care (PHC) visits due to respiratory diseases as main illness increased with a 10 μg/m3 increase in NO2 in all five municipalities in multi-pollutant models, but were only statistically significant in Malmö, with a 1.85% increase
Summary
Respiratory diseases are one of the leading causes of both morbidity and mortality worldwide [1,2]. Chronic obstructive pulmonary diseases (COPD), asthma, and lung cancer are main contributors of both respiratory-related mortality and morbidity [3]. In the European Union (EU), respiratory diseases are responsible for 7% of the total number of hospital admissions [4], and it has been estimated that one in eight deaths is directly attributed to respiratory illness [4]. By 2030, the WHO estimates that respiratory diseases will be the major cause of impaired quality of life and death in the EU and that it will require substantial economic resources to both prevent and treat. Res. Public Health 2017, 14, 587; doi:10.3390/ijerph14060587 www.mdpi.com/journal/ijerph
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