Hanne Krage Carlsen1,2,3, Unnur Valdimarsdóttir4,5,6, Haraldur Briem7, Francesca Dominici5, Ragnhildur Gudrun Finnbjornsdottir8, Thorsteinn Jóhannsson8, Thor Aspelund9, Thorarinn Gislason10,11, Thorolfur Gudnason7. 1. Centre of Public Health Sciences, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland. hkc1@hi.is. 2. Environment and Natural resources, University of Iceland, Sturlugata 7, University of Iceland, 102, Reykjavík, Iceland. hkc1@hi.is. 3. Section of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Medicinaregatan 16A, 40530, Gothenburg, Sweden. hkc1@hi.is. 4. Centre of Public Health Sciences, University of Iceland, Sturlugata 8, Reykjavík, 102, Iceland. 5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA. 6. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 6, SE-171 77, Stockholm, Sweden. 7. Chief Epidemiologist, Directorate of Health, Centre for Health Threats and Communicable Diseases, Barónsstigur 57, 101, Reykjavík, Iceland. 8. The Environment Agency of Iceland, Suðurlandsbraut 24, 108, Reykjavík, Iceland. 9. School of Health Sciences, University of Iceland, Sæmundargata 2, 101, Reykjavík, Iceland. 10. Landspitali - the National University Hospital, Fossvogur, 108, Reykjavík, Iceland. 11. Faculty of medicine, University of Iceland, Vatnsmýrarvegi 16, 101, Reykjavík, Iceland.
Abstract
BACKGROUND: The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO2). The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area. METHODS: Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO2 concentration and high SO2 levels (24-h mean SO2 > 125 μg/m3) were analysed using generalized additive models. RESULTS: After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39-1.58%) per 10 μg/m3 at lag 0-2, in PCMD for respiratory causes 1.26% (95% CI 0.72-1.80%) per 10 μg/m3 SO2 at lag 0-2, and in HED by 1.02% (95% CI 0.02-2.03%) per 10 μg/m3 SO2 at lag 0-2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1-19.6%), 17.2% (95% CI 10.0-24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49-1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54-1.71%) and 2.08% (1.13-3.04%). CONCLUSION: High levels of volcanic SO2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible.
BACKGROUND: The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO2). The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area. METHODS: Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO2 concentration and high SO2 levels (24-h mean SO2 > 125 μg/m3) were analysed using generalized additive models. RESULTS: After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39-1.58%) per 10 μg/m3 at lag 0-2, in PCMD for respiratory causes 1.26% (95% CI 0.72-1.80%) per 10 μg/m3 SO2 at lag 0-2, and in HED by 1.02% (95% CI 0.02-2.03%) per 10 μg/m3 SO2 at lag 0-2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1-19.6%), 17.2% (95% CI 10.0-24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49-1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54-1.71%) and 2.08% (1.13-3.04%). CONCLUSION: High levels of volcanic SO2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible.
Entities:
Keywords:
Atmospheric transport; Epidemiology; Public health; Respiratory disease; Volcanic eruption
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