242747 Measuring the acute health effects of dust storms: A matched case-control series

Wednesday, November 2, 2011

Michael Gdalevich, MD, MPH , Ben Gurion University, Department of Epidemiology, Barzilai Medical Center, Ashkelon, Israel
Esti Nissan, PhD , Department of Economics, Ben Gurion University, Beer Sheva, Israel
Levana Kordova-Biezuner, PhD , National Air Monitoring Network, Israel Ministry of Environmental Protection, Tel Aviv, Israel
Itamar Grotto, MD, MPH, PhD , Epidemiology Department, Ben-Gurion University of the Negev and the Ministry of Health, Je, Israel
Shimon Scharf , Ben Gurion University - Barzilai Medical Center Campus, Ashkelon, Israel
David Broday, PhD , Technion, Israel Institute of Technology, Haifa, Israel
Michael Huerta, MD, MPH , Ben Gurion University - Barzilai Medical Center Campus, Ashkelon, Israel
Background and Objectives: Transcontinental sandstorms are frequent in the eastern Mediterranean basin, with southeasterly winds transporting dust from the Sahara desert. The resulting ambient particulate matter is a potential health hazard for exposed populations. We aimed to quantify the extent of acute cardio-respiratory health effects attributable to sandstorms in an Eastern Mediterranean region.

Methods: Continuous air quality monitoring is carried out by the Israel Ministry of Environmental Protection. We identified all sandstorm days (SSDs) for the period between January 2006 and December 2008. For each of these "case" days, we selected 2 non-sandstorm control days from the previous and the subsequent fortnights, matching them for day of the week. The number of emergency department (ED) visits for acute cardio-respiratory conditions at a regional medical center (Barzilai Medical Center) was counted for each SSD for and its matched control days. SSD counts were compared to mean matched counts using the paired t-test.

Results: 48 SSDs and 96 matched control days were identified during the 3-year study period. Mean cardio-respiratory patient load on SSDs was 23.239.8 visits, compared to 21.158.14 on matched control days (p=0.017). This represents a relative increase of 9.8% over the expected patient load. In absolute terms, and based on the medical center's estimated catchment population, this represents an increase of approximately 1 ED visit per 100,000 for one SSD, translating to about 70 ED visits in the country.

Conclusion: While sandstorms are a detectable risk factor for acute cardio-respiratory syndromes, the de-facto impact of exposure in our area appears to be low. This finding may an indirect indicator of the effectiveness of the Ministry of Environmental Protection's pre-storm warning system, which appeals through the mass media to predisposed persons to remain indoors on SSDs.

Learning Areas:
Environmental health sciences

Learning Objectives:
Define and quantify health effects of dust storm in Southern Israel Analyze the additional patien load incurred by dust storms Formulate public policy for dust storm warning and preparedness

Keywords: Air Quality, Health Risks

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have planned the study, took part in data collection , have lead the analysis and reporting of findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.