The use of asthma and allergy medicines is associated with exposure to smoking

Abstract

Exposure to ambient air pollution and tobacco smoking have been reported to trigger asthma and allergies, but these risk factors have typically not been assessed together. Here we collected and analysed daily wastewater samples from an urban population of approximately 500,000 people in Southern China between November 2017 and October 2018 for biomarkers of asthma and allergy medicines and exposure to tobacco smoke. Daily air pollution data (PM2.5, PM10, SO2, NO2, CO and O3) were obtained from the nearest air quality monitoring station. Using time-series linear regression, we show a significantly higher use of antihistamine medicines in spring and in autumn, associated with peak pollen levels, but with no significant association between the use of asthma and allergy medications and ambient air pollution levels. There were significant positive associations between biomarkers of exposure to tobacco smoke and the use of selected medicines. Wastewater-based epidemiology can be a cost-effective way to assess the health impacts of multiple environmental factors at the population level. The exposure to both air pollution and cigarette smoke can trigger asthma. Wastewater surveillance was used to demonstrate the possibility of distinguishing between these two factors.