Olivier Laurent1, Gaëlle Pedrono2, Laurent Filleul3, Claire Segala2, Agnès Lefranc4, Charles Schillinger5, Emmanuel Rivière5, Denis Bard6. 1. LERES, Ecole des Hautes Etudes en Santé Publique, Rennes. 2. SEPIA Santé, Baud. 3. CIRE Aquitaine, Institut de Veille Sanitaire, Bordeaux. 4. Département Santé Environnement, Institut de Veille Sanitaire, Saint Maurice. 5. Association pour la Surveillance et l'Etude de la Pollution Atmosphérique en Alsace, Schiltigheim. 6. LERES, Ecole des Hautes Etudes en Santé Publique, Rennes. Electronic address: denis.bard@ehesp.fr.
Abstract
BACKGROUND: Air pollution triggers asthma attacks hours to days after exposure. It remains unclear whether socioeconomic deprivation modulates these effects. Investigation of these interactions requires adequate statistical power, obtainable by using either a sufficient number of observations or very sensitive indicators of asthma attacks. Using a small-area temporal ecologic approach, we studied the short-term relations between ambient air pollution and sales of short-acting beta-agonist (SABA) drugs, a frequent and specific treatment for control of asthma attacks in children and young adults, and then tested the influence of deprivation on these relations. METHODS: The study took place in Strasbourg, France in 2004. Health insurance funds provided data on 15,121 SABA sales for patients aged 0 to 39 years. Deprivation was estimated by small geographic areas using an index constructed from census data. Daily average ambient concentrations of particulate matter (particles with an aerodynamic diameter < 10 microm [PM(10)]), nitrogen dioxide (NO(2)), and ozone (O(3)) were modeled on a small-area level. Adjusted case-crossover models were used for statistical analysis. RESULTS: Increased of 10 microg/m(3) in ambient PM(10), NO(2), and O(3) concentrations were associated, respectively, with increases of 7.5% (95% confidence interval [CI], 4 to 11.2%), 8.4% (95% CI, 5 to 11.9%), and 1% (95% CI, - 0.3 to 2.2%) in SABA sales. Deprivation had no influence on these relations. CONCLUSION: The associations observed are consistent with those reported by studies focusing on SABA use. Similar studies in other settings should confirm whether the lack of interaction with deprivation is due to specific local conditions.
BACKGROUND: Air pollution triggers asthma attacks hours to days after exposure. It remains unclear whether socioeconomic deprivation modulates these effects. Investigation of these interactions requires adequate statistical power, obtainable by using either a sufficient number of observations or very sensitive indicators of asthma attacks. Using a small-area temporal ecologic approach, we studied the short-term relations between ambient air pollution and sales of short-acting beta-agonist (SABA) drugs, a frequent and specific treatment for control of asthma attacks in children and young adults, and then tested the influence of deprivation on these relations. METHODS: The study took place in Strasbourg, France in 2004. Health insurance funds provided data on 15,121 SABA sales for patients aged 0 to 39 years. Deprivation was estimated by small geographic areas using an index constructed from census data. Daily average ambient concentrations of particulate matter (particles with an aerodynamic diameter < 10 microm [PM(10)]), nitrogen dioxide (NO(2)), and ozone (O(3)) were modeled on a small-area level. Adjusted case-crossover models were used for statistical analysis. RESULTS: Increased of 10 microg/m(3) in ambient PM(10), NO(2), and O(3) concentrations were associated, respectively, with increases of 7.5% (95% confidence interval [CI], 4 to 11.2%), 8.4% (95% CI, 5 to 11.9%), and 1% (95% CI, - 0.3 to 2.2%) in SABA sales. Deprivation had no influence on these relations. CONCLUSION: The associations observed are consistent with those reported by studies focusing on SABA use. Similar studies in other settings should confirm whether the lack of interaction with deprivation is due to specific local conditions.
Authors: Cassandra R O'Lenick; Andrea Winquist; Howard H Chang; Michael R Kramer; James A Mulholland; Andrew Grundstein; Stefanie Ebelt Sarnat Journal: Environ Res Date: 2017-03-22 Impact factor: 6.498
Authors: Mark Ashworth; Antonis Analitis; David Whitney; Evangelia Samoli; Sofia Zafeiratou; Richard Atkinson; Konstantina Dimakopoulou; Sean Beavers; Joel Schwartz; Klea Katsouyanni Journal: Environ Health Date: 2021-05-07 Impact factor: 5.984
Authors: Cassandra R O' Lenick; Howard H Chang; Michael R Kramer; Andrea Winquist; James A Mulholland; Mariel D Friberg; Stefanie Ebelt Sarnat Journal: Environ Health Date: 2017-04-05 Impact factor: 5.984
Authors: Elizabeth A Richardson; Jamie Pearce; Helena Tunstall; Richard Mitchell; Niamh K Shortt Journal: Int J Health Geogr Date: 2013-07-16 Impact factor: 3.918