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Vol. 152. Issue 9.
Pages 333-338 (May 2019)
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Vol. 152. Issue 9.
Pages 333-338 (May 2019)
Original article
DOI: 10.1016/j.medcle.2019.02.016
Association between air pollution and asthma exacerbations in Badalona, Barcelona (Spain), 2008–2016
Asociación entre la contaminación ambiental y las agudizaciones de asma bronquial en Badalona (Barcelona), 2008–2016
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Carlos Martínez-Riveraa,b,d, Ignasi Garcia-Olivéa,b,c,d,
Corresponding author
ignasi.g.olive@gmail.com

Corresponding author.
, Zoran Stojanovica,c,d, Joaquim Raduae,f,g,d, Juan Ruiz Manzanoa,b,c,d, Jorge Abad-Capaa,b,c,d
a Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
b Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
c Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, Spain
d Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, Spain
e Department of Statistics, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, Spain
f Ciber de Salud Mental (CiberSam), Madrid, Spain
g Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Estocolmo, Sweden
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Tables (4)
Table 1. Description of the environmental and meteorological variables daily values during the study period (2008–2016).
Table 2. Difference between the values of the variables on days when an event occurred (ER visit or hospitalisation) compared to days when no event occurred during the study period (2008–2016).
Table 3. Association between environmental variables and the number of hospitalisations for exacerbation of bronchial asthma.
Table 4. Association between environmental variables and the number of ER visits for exacerbation of bronchial asthma.
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Abstract
Introduction and objective

Air pollution has been widely associated with respiratory diseases. Nevertheless, association between air pollution and exacerbations of asthma in our area has been less studied. To analyse the effect of air pollution on exacerbations of asthma in Badalona.

Material and methods

This was an observational study conducted in Badalona. The number of daily hospital admissions and accident and emergency visits related to exacerbation of asthma between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, atmospheric pressure, relative humidity, and NO2, SO2 and CO levels on asthma-related emergencies and hospitalisations the same day and 1–4 days after. All p-values were corrected for multiple comparisons.

Results

The number of hospitalisations was associated with low temperature (lags 0–4) and higher levels of NO2 (lags 0, 1, 2 and 4) and atmospheric pressure (lags 2 and 3). The number of accident and emergency visits was associated with low temperature (lags 0–4) and higher levels of NO2 (lags 2, 3 and 4).

Conclusions

The number of accident and emergency visits and hospitalisations for exacerbation of asthma is associated with higher levels of NO2 and with lower temperatures.

Keywords:
Asthma
Exacerbation
Pollution
Nitrogen dioxide
NO2
Resumen
Introducción y objetivo

La relación entre la contaminación ambiental y las enfermedades respiratorias ha sido ampliamente descrita, pero existen menos trabajos referentes a la contaminación y asma en nuestro medio. El objetivo del estudio fue analizar el efecto de la contaminación ambiental sobre las agudizaciones de asma.

Material y métodos

Se trata de un estudio observacional. Se incluyeron en el análisis los ingresos hospitalarios diarios y las consultas a urgencias diarias en el Hospital Universitari Germans Trias i Pujol (Badalona, Barcelona) entre 2008 y 2016 de aquellos pacientes con diagnóstico de asma agudizada. Se obtuvieron los valores diarios de temperatura, humedad relativa, presión atmosférica y los niveles de NO2, SO2 y CO. Mediante regresión de Poisson simple se estudió la asociación entre estos factores y el número de hospitalizaciones y urgencias mediante regresiones simples para el mismo día y para entre uno y 4 días más tarde (lags 0 a 4). Se corrigió el efecto de las múltiples comparaciones.

Resultados

Se asociaron con un incremento en las hospitalizaciones por asma la baja temperatura (lags 0 a 4) y los incrementos en los niveles de NO2 (lags 0, 1, 2 y 4) y presión atmosférica (lags 2 y 3). Al analizar las urgencias, estas se asociaron con la baja temperatura (lags 0, 1, 2, 3 y 4) y los incrementos en los niveles de NO2 (lags 2, 3 y 4).

Conclusiones

La baja temperatura y la elevada concentración ambiental de NO2 se asocian con un incremento en las consultas a urgencias y hospitalizaciones por agudización de asma bronquial.

Palabras clave:
Asma bronquial
Agudización
Contaminación
Dióxido de nitrógeno
NO2

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