https://doi.org/10.4081/monaldi.2023.2511
Air pollution and its effects on emergency room visits in tertiary respiratory care centers in Delhi, India
Submitted: December 30, 2022
Accepted: February 15, 2023
Published: February 23, 2023
Accepted: February 15, 2023
Abstract Views: 1335
PDF: 478
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Environmental pollution has harmful effects on human health, particularly the respiratory system. We aimed to study the impact of daily ambient air pollution on daily emergency room visits for acute respiratory symptoms. This study was conducted in two tertiary respiratory care centres in Delhi, India. Daily counts of emergency room visits were collected. All patients attending the emergency room were screened for acute onset (less than 2 weeks) of respiratory symptoms and were recruited if they were staying in Delhi continuously for at least 4 weeks and having onset (≤2 weeks) of respiratory symptoms. Daily average air pollution data for the study period was obtained from four continuous ambient air quality monitoring stations. A total of 61,285 patients were screened and 11,424 were enrolled from June 2017 to February 2019. Cough and difficulty in breathing were most common respiratory symptoms. Poor air quality was observed during the months of October to December. Emergency room visits with acute respiratory symptoms significantly increased per standard deviation increase in PM10 from lag days 2-7. Increase in wheezing was primarily seen with increase in NO2. Pollutant levels have effect on acute respiratory symptoms and thus influence emergency room visits.
***************************************************************
*Appendix Authors list
Kamal Singhal,1 Kana Ram Jat,2 Karan Madan,3 Mohan P. George,4 Kalaivani Mani,5 Randeep Guleria,3 Ravindra Mohan Pandey,5 Rupinder Singh Dhaliwal,6 Rakesh Lodha,2 Varinder Singh1
1Department of Paediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India
2Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
3Department of Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
4Department of Environment, Delhi Pollution Control Committee, Kashmere Gate, New Delhi, India
5Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
6Department of Non-communicable Diseases, Indian Council of Medical Research, New Delhi, India
Manisalidis I, Stavropoulou E, Stavropoulos A, Bezirtzoglou E. Environmental and health impacts of air pollution: a review. Front Public Health 2020;8:14.
Laumbach RJ, Kipen HM. Respiratory health effects of air pollution: update on biomass smoke and traffic pollution. J Allergy Clin Immunol 2012;129:3-11.
Brook RD, Franklin B, Cascio W, et al. Air pollution and cardiovascular disease: a statement for healthcare professionals from the expert panel on population and prevention science of the American heart association. Circulation 2004;109:2655-71.
Jiang XQ, Mei XD, Feng D. Air pollution and chronic airway diseases: what should people know and do? J Thorac Dis 2016;8:E31-40.
Faustini A, Stafoggia M, Colais P, et al. Air pollution and multiple acute respiratory outcomes. Eur Respir J 2013;42:304-13.
Ren Z, Liu X, Liu T, et al. Effect of ambient fine particulates (PM2.5) on hospital admissions for respiratory and cardiovascular diseases in Wuhan, China. Respir Res 2021;22:128.
Kirwa K, Eckert CM, Vedal S, et al. Ambient air pollution and risk of respiratory infection among adults: evidence from the multiethnic study of atherosclerosis (MESA). BMJ Open Respir Res 2021;8:e000866.
Chauhan AJ, Johnston SL. Air pollution and infection in respiratory illness. Br Med Bull 2003;68:95-112.
Kurt OK, Zhang J, Pinkerton KE. Pulmonary health effects of air pollution. Curr Opin Pulm Med 2016;22:138-43.
Halonen JI, Lanki T, Yli-Tuomi T S, et al. Urban air pollution, and asthma and COPD hospital emergency room visits. Thorax 2008;63:635-41.
Villeneuve PJ, Chen L, Rowe BH, Coates F. Outdoor air pollution and emergency department visits for asthma among children and adults: a case-crossover study in northern Alberta, Canada. Environ Health 2007;6:40.
Peel JL, Tolbert PE, Klein M, et al. Ambient air pollution and respiratory emergency department visits. Epidemiology 2005;16:164-74.
Zheng XY, Ding H, Jiang L, et al. Association between air pollutants and asthma emergency room visits and hospital admissions in time series studies: a systematic review and meta-analysis. PLoS One 2015;10:e0138146.
Hwang SH, Lee JY, Yi SM, Kim H. Associations of particulate matter and its components with emergency room visits for cardiovascular and respiratory diseases. PLoS One 2017;12:e0183224.
Balakrishnan K, Ganguli B, Ghosh S, et al. Part 1. Short-term effects of air pollution on mortality: results from a time-series analysis in Chennai, India. Res Rep Health Eff Inst 2011;(157):7-44.
Rajarathnam U, Sehgal M, Nairy S, et al. Part 2. Time-series study on air pollution and mortality in Delhi. Res Rep Health Eff Inst 2011;(157):47-74.
Joshi P, Ghosh S, Dey S, et al. Impact of acute exposure to ambient PM2.5 on non-trauma all-cause mortality in the megacity Delhi. Atmos Environ 2021;259:118548.
Maji S, Ahmed S, Siddiqui WA, Ghosh S. Short term effects of criteria air pollutants on daily mortality in Delhi, India. Atmos Environ 2017;150:210-9.
Maji S, Ghosh S, Ahmed S. Association of air quality with respiratory and cardiovascular morbidity rate in Delhi, India. Int J Environ Health Res 2018;28:471-90.
Gupta U. Valuation of urban air pollution: a case study of Kanpur City in India. Environ Resour Econ 2008;41:315-26.
Agarwal R, Jayaraman G, Anand S, Marimuthu P. Assessing respiratory morbidity through pollution status and meteorological conditions for Delhi. Environ Monit Assess 2006;114:489-504.
Manojkumar N, Srimuruganandam B. Health effects of particulate matter in major Indian cities. Int J Environ Health Res 2021;31:258-70.
Pande JN, Bhatta N, Biswas D, et al. Outdoor air pollution and emergency room visits at a hospital in Delhi. Indian J Chest Dis Allied Sci 2002;44:13-9.
Jayaraman G, Nidhi. Air pollution and associated respiratory morbidity in Delhi. Health Care Manag Sci 2008;11:132-8.
Abelsohn A, Stieb DM. Health effects of outdoor air pollution: approach to counseling patients using the Air Quality Health Index. Can Fam Physician 2011;5:881-7, e280-7.
Centers for Disease Control and Prevention. Air pollutants. 2021. Available from: https://www.cdc.gov/air/pollutants.htm. Accessed: 2022 June 2022.
Canova C, Torresan S, Simonato L, et al. Carbon monoxide pollution is associated with decreased lung function in asthmatic adults. Eur Respir J 2010;35:266-72.
Tian L, Qiu H, Pun VC, et al. Ambient carbon monoxide associated with reduced risk of hospital admissions for respiratory tract infections. Am J Respir Crit Care Med 2013;188:1240-5.
Sunyer J, Atkinson R, Ballester F, et al. Respiratory effects of sulphur dioxide: a hierarchical multicity analysis in the APHEA 2 study. Occup Environ Med 2003;60:e2.
Vepkhvadze N, Kiladze N, Khorbaladze M, et al. Impact of sulphur dioxide on the respiratory system of Tbilisi population. Georgian Med News 2017;(265):1114-9.
Xing YF, Xu YH, Shi MH, Lian YX. The impact of PM2.5 on the human respiratory system. J Thorac Dis 2016;8:E69-74.
Kyung SY, Jeong SH. Particulate-matter related respiratory diseases. Tuberc Respir Dis (Seoul) 2020;83:116-21.
Kim SY, Kim E, Kim WJ. Health effects of ozone on respiratory diseases. Tuberc Respir Dis (Seoul) 2020;83:S6-11.
Anenberg SC, Henze DK, Tinney V, et al. Estimates of the global burden of ambient PM2.5, ozone, and NO2 on asthma incidence and emergency room visits. Environ Health Perspect 2018;126:107004.
Tenias JM, Ballester F, Rivera ML. Association between hospital emergency visits for asthma and air pollution in Valencia, Spain. Occup Environ Med 1998;55:541-7.
Meng YY, Yue D, Molitor J, et al. Reductions in NO2 and emergency room visits associated with California’s goods movement policies: a quasi-experimental study. Environ Res 2022;213:113600.
Kowalska M, Skrzypek M, Kowalski M, Cyrys J. Effect of NOx and NO2 concentration increase in ambient air to daily bronchitis and asthma exacerbation, Silesian Voivodeship in Poland. Int J Environ Res Public Health 2020;1:E754.
Szyszkowicz M, Kousha T, Castner J, Dales R. Air pollution and emergency department visits for respiratory diseases: a multi-city case crossover study. Environ Res 2018;163:263-9.
Ting MJ, Chen YT, Tien AJ, et al. PM2.5 and emergency room visits for mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease. Eur Resp J 2019;54:4407.
Fan J, Li S, Fan C, et al. The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis. Environ Sci Pollut Res Int 2016;23:843-50.
Saha A, Marma KKS, Rashid A, et al. Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh. PLoS One 2022;17:e0269622.
Pandey JS, Kumar R, Devotta S. Health risks of NO2, SPM and SO2 in Delhi (India). Atmos Environ 2005;39:6868-74.
Adebayo-Ojo TC, Wichmann J, Arowosegbe OO, et al. Short-term joint effects of PM10, NO2 and SO2 on cardio-respiratory disease hospital admissions in Cape Town, South Africa. Int J Environ Res Public Health 2022;19:495.
Castner J. Ozone alerts and respiratory emergencies: the environmental protection agency’s potential biological pathways for respiratory effects. J Emerg Nurs 2020;46:413-9.e2.
Kousha T, Rowe B. Ambient ozone and emergency department visits due to lower respiratory condition. Int J Occup Med Environ Health 2014;27:50-9.
Ethics Approval
The Institutional Ethical committees of both VPCI(VPCI/DIR/IHEC/2017/8) and NITRD (NITRD/EC/2017/2786) approved the study.Supporting Agencies
Indian Council of Medical Research, New Delhi, India (No: 68/33/2015-NCD-I).How to Cite
Kumar, Raj, Parul Mrigpuri, Rohit Sarin, Jitendra Kumar Saini, Rashmi Yadav, Aditya Nagori, Sushil Kumar Kabra, Arpana Mukherjee, and Geetika Yadav. 2023. “Air Pollution and Its Effects on Emergency Room Visits in Tertiary Respiratory Care Centers in Delhi, India”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2511.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Elio Gorga, Marta Scodro, Francesca Valentini, Renzo D'Ortona, Mariachiara Arisi, Edoardo Sciatti, Ivano Bonadei, Valentina Regazzoni, Enrico Vizzardi, Marco Metra, Piergiacomo Calzavara Pinton, Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Marzia Vassalini, Andrea Verzeletti, Francesco De Ferrari, Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
- Simona Giampaoli, Giovanni Viscogliosi, Diego Vannuzzo, We all want to live longer, but not grow old , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- P. Trerotoli, N. Bartolomeo, A.M. Moretti, Hospitalisation for COPD in Puglia: the role of hospital discharge database to estimate prevalence and incidence , Monaldi Archives for Chest Disease: Vol. 69 No. 3 (2008): Pulmonary series
- I. Blanco, H. Canto, J. Flóres, C. Camblor, V. Cárcaba, F.J. de Serres, S. Janciauskiene, E.F. Bustillo, Long-term augmentation therapy with Alpha-1 Antitrypsin in an MZ-AAT severe persistent asthma , Monaldi Archives for Chest Disease: Vol. 69 No. 4 (2008): Pulmonary series
- Susanna Ricotti, Valentina Martinelli, Patrick Caspani, Serena Monteleone, Lucia Petrucci, Elena Dalla Toffola, Catherine Klersy, Changes in quality of life and functional capacity after lung transplantation: A single-center experience , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Mariangela Rondanelli, Francesca Monteferrario, Simone Perna, Milena Anna Faliva, Annalisa Opizzi, Health-promoting properties of artichoke in preventing cardiovascular disease by its lipidic and glycemic-reducing action , Monaldi Archives for Chest Disease: Vol. 80 No. 1 (2013): Cardiac series
- H. Sumikawa, T. Johkoh, N. Tomiyama, S. Hamada, M. Koyama, M. Tsubamoto, S. Murai, A. Inoue, H. Nakamura, T. Tachibana, N.L. Müller, Pulmonary Alveolar Microlithiasis: CT and pathologic findings in 10 patients , Monaldi Archives for Chest Disease: Vol. 63 No. 1 (2005): Pulmonary series
- Sergio C. Conte, Giulia Spagnol, Marco Confalonieri, Beatrice Brizi, Deep sedation versus minimal sedation during endobronchial ultrasound transbronchial needle aspiration , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- G. Ferrante, M. Simoni, F. Cibella, F. Ferrara, G. Liotta, V. Malizia, G. Corsello, G. Viegi, S. La Grutta, Third-hand smoke exposure and health hazards in children , Monaldi Archives for Chest Disease: Vol. 79 No. 1 (2013): Pulmonary series
You may also start an advanced similarity search for this article.
