Frequency of patients with acute asthma in relation to ozone, nitrogen dioxide, other pollutants of ambient air and meteorological observations

Abstract

 Objective. To study the association of the daily frequency of registration of patients with acute asthma at the emergency department of a central hospital in the south-west of Sweden with levels of air pollution and meteorological observations. Methods. A retrospective longitudinal study was made of asthma patients taken from a hospital registry. This information was correlated with measurements of ozone, nitrogen dioxide, sulphur dioxide, toluene, temperature and relative humidity. Patients were from the catchment area of the Central Hospital of Halmstad containing around 120 000 inhabitants. A total of 4127 visits of patients with acute asthma to the emergency department at the Central Hospital of Halmstad were registered during a period of 1247 days from January 1990 to May 1993. The differential optical absorption spectroscopy (DOAS) technique was used to monitor levels of air pollutants over a distance of 1000 m in the central part of the town of Halmstad. Data on temperature, relative humidity, precipitation, wind speed and wind direction for the time period were supplied by the Swedish Meteorological and Hydrological Institute (SMHI). Results. There were many statistically significant correlations between the levels of air pollutants and the meteorological measurements and a strong negative correlation between ozone and nitrogen dioxide. There was a statistically significant effect on asthma visits in children of low temperature and high nitrogen dioxide levels, and on asthma visits in adults of high temperature and high levels of ozone. Conclusions. There was a different reaction pattern in children and adults with asthma regarding temperature and ozone/nitrogen dioxide. The strong correlations between temperature and air pollution and between the levels of ozone and nitrogen dioxide made the true relation between asthma, air pollution and temperature hard to evaluate statistically.