Air pollution poses a major health risk especially in those patients with airway diseases. In their 2007 State of the Air report, the American Lung Association ranked Fresno as having the 3rd worst 24-hour average PM2.5 pollution in the nation. Therefore, we collected data from a teaching hospital to assess the impact of varying PM2.5, NO2 and ozone level in Fresno on ER visits and admissions, in patients with Asthma and COPD.
From computerized medical records, all patients seen in the ER and admitted with a diagnosis of Asthma or Chronic Obstructive Pulmonary Disease from August 2005 through August 2008 were identified using ICD 9 codes (466, 490, 491, 493). From this cohort, we gathered demographics, clinical and laboratory data on a standardized database. Furthermore, correlation was analyzed between weekly admission rates and ambient air pollution indices provided by San Joaquin Air Board using General Linear Modeling.
There were 1184 ER visits in total with a predominance of female subjects (60%). Of the total ER visits, 932 (79%) subjects were admitted and 24 (2.0%) were ICU admissions. The mean age of the African American (54) and Hispanic (58) subjects were significantly lower than the Caucasian (62) and Asian (65) subjects (all p < 0.01). Among the 507 (43%) smokers, a significantly higher proportion of Caucasians and African American used tobacco than Hispanic and Asian subjects (p < 0.01). Table 1 shows the correlation between ambient PM2.5, Ozone level, NO2 and mean temperature to weekly ER visits.
Increased ambient PM2.5 level was associated with an increase in weekly ER visits. There was no association between ambient Ozone level and weekly ER visits from respiratory illness. Ambient temperature may have an additional influence on ER visits.
Air pollution has a greater impact on patients with chronic airway disease than ambient Ozone level.
Jagruti Patel, University grant monies Dr. Joseph has received a grant funding from San Jauquin Air Board for conducting a study on human biomarkers for air pollution; Consultant fee, speaker bureau, advisory committee, etc. Dr. Joseph is a speaker for Astra Zenica; No Product/Research Disclosure Information