The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4032.0: Tuesday, November 18, 2003 - 9:24 AM

Abstract #66959

Air Pollution and Aeroallergens as Predictors of Asthma-related Healthcare Utilization

Melissa W. McClung1, Richard H. Jones, PhD2, Richard L. Vogt, MD3, Andrew H. Liu, MD4, and Arthur J. Davidson, MD, MSPH1. (1) Denver Center for Public Health Preparedness, Denver Public Health Department, 605 Bannock St., Denver, CO 80204, (303) 436-8994,, (2) Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Box B-119, Denver, CO 80262, (3) Tri-County Health Department, 7000 East Belleview, Suite #301, Greenwood Village, CO 80111, (4) Pediatric Allergy & Immunology, National Jewish Medical and Research Center, 1400 Jackson St., Denver, CO 80206

Background: Pollens, fungal spores and air pollutants such as ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM10, PM2.5) have been shown to exacerbate asthma, however their effect on asthma-related healthcare utilization is less clear. Objective: To explore the relationship between 3 types of asthma-related health care utilization and air pollutants and aeroallergens in Denver, Colorado. Methods: Within an integrated healthcare system (Denver Health), 3 years of asthma-related healthcare utilization ([ARHU] i.e., outpatient, urgent care and inpatient admissions) were analyzed using Poisson regression with daily and 7-day moving average (7DMA) air pollution measures and aeroallergen counts. Seasonal trend, linear trend, daily average temperature, day of the week and holidays were controlled for. Results: Significant associations included PM10 and outpatient and inpatient visits and NO2 and urgent care visits. A 10 µg/m3 daily PM10 level increase was associated with a 29.6% increase (95% confidence interval [CI] 9.9, 52.8) in asthma-related winter admissions, and a 10 µg/m3 increase in the PM10 7DMA resulted in a 5.4 percent increase (95% CI 2.6, 8.4) in annual outpatient visits. During winter, a 45.1% (95% CI 13.1, 86.3) urgent care visit increase was observed with 0.01 ppm increase in NO2 7DMA levels. No associations were found between utilization and pollens or fungal spores. Conclusions: Below national air quality standards, PM10 and NO2 were associated with increased ARHU. Monitoring these pollutants may help predict increases in ARHU.

Learning Objectives:

Keywords: Asthma, Air Pollutants

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Denver Center for Public Health Preparedness, Denver Public Health, Denver Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Environmental Toxics - Exploring the Association Between Environmental Toxics and Health

The 131st Annual Meeting (November 15-19, 2003) of APHA