Use of outpatient clinics as a health indicator for communities around a coal-fired power plant.

The permit to operate the first coal fired power plant in Israel was issued with the condition that a comprehensive network to monitor its effects on the environment, health, and agriculture must be installed and operated around the plant. The health monitoring system consists of four studies, which started 1 year prior to the operation of the plant and were carried out for 10 years. In the framework of the health monitoring system, a study of requests for health services was carried out. In this survey, 8 clinics of the Sick Fund, served by 16 physicians, were followed up. The clinics were located as near as possible to air pollution monitoring stations and represent expected different levels of pollution. A health recorder summarized each day's visits to each physician and tabulated the total visits for each day and the visits due to respiratory tract complaints. Multivariate stepwise regressions on total as well as on respiratory complaints were carried out. The independent variables in the regressions were sulfur dioxide, meteorological parameters (such as temperature and humidity), and flu epidemics. Temperature was almost always significantly correlated with respiratory complaints, but less correlated with total visits among, adults and children. Sulfur dioxide, most meterological parameters and flu epidemics were not meaningful explanatory factor in the regressions. Ambient air pollution levels did not exceed the Israeli air quality or the more stringent local air quality standards, the monthly and annual average sulfur dioxide and nitrogen oxides values were very low.