Using smartphone technology to reduce health impacts from atmospheric environmental hazards

F H Johnston,I S Koolhof,G J Williamson,S L Campbell,P J Jones,C Lucani,D M J S Bowman,N B Cooling,A J Wheeler

doi:10.1088/1748-9326/aab1e6

Abstract

Background: Global environmental change is exacerbating human vulnerability to adverse atmospheric conditions including air pollution, aeroallergens such as pollen, and extreme weather events. Public information and advisories are a central component of responses to mitigate the human impacts of environmental hazards. Digital technologies are emerging as a means of providing personalised, timely and accessible warnings.Method: We describe AirRater, an integrated online platform that combines symptom surveillance, environmental monitoring, and notifications of changing environmental conditions via a free smartphone app. It was developed and launched in Tasmania, Australia (population 510 000), with the aim of reducing health impacts and improving quality of life in people with conditions such as asthma and allergic rhinitis. We present environmental data, user uptake and results from three online evaluation surveys conducted during the first 22 months of operation, from October 2015 through August 2017.Results: There were 3,443 downloads of the app from all regions of Tasmania. Of the 1,959 individuals who registered, 79% reported having either asthma or allergic rhinitis. Downloads increased during adverse environmental conditions and following publicity. Symptom reports per active user were highest during spring (72%), lowest in autumn (37%) and spiked during periods of reduced air quality. In response to online surveys, most users reported that the app was useful and had improved their understanding of how environmental conditions affect their health, and in some cases had prompted action such as the timely use of medication.Conclusion: Active engagement and consistent positive feedback from users demonstrates the potential for considerable individual, clinical and wider public health benefits from integrated and personalised monitoring systems such as AirRater. The perceived health benefits require objective verification, and such systems need to address several challenges in providing timely, reliable and valid environmental data.

Highlights

Introduction and purposeGlobal environmental change is exacerbating human vulnerability to atmospheric environmental hazards including air pollution, aeroallergens and extreme weather events
User evaluation We evaluated the use of the AirRater app using information from the following sources: (a) Apple and Google store data, which report the daily number of app downloads, the AirRater server which logs the number of unique users, daily usage, and symptom reports; (b) the registration questionnaire, which includes health and demographic information; and (c) user evaluation surveys
While only 11% of participants in this study reported that they discussed results with their health professional, there is potential for the data generated by AirRater to inform more evidence-based decisions around pollen treatment including immunotherapy [49]

Summary

Introduction

Global environmental change is exacerbating human vulnerability to atmospheric environmental hazards including air pollution, aeroallergens (such as pollen) and extreme weather events. A warming climate has brought more frequent heatwaves and other extreme weather events, which interact with air pollution to increase population health risk [4]. Population exposures and resultant sensitization to aeroallergens have increased in many temperate landscapes in both the northern [6], and southern hemispheres [7] due to the global spread of plants known to be allergenic, through the lengthening of pollen seasons, and the increased abundance of pollens in response to anthropogenic climate change, including higher concentrations of carbon dioxide [8]. Global environmental change is exacerbating human vulnerability to adverse atmospheric conditions including air pollution, aeroallergens such as pollen, and extreme weather events. Digital technologies are emerging as a means of providing personalised, timely and accessible warnings

Results

Discussion

Conclusion