Ambient air pollution and emergency department visits in Toronto, Canada
- DOI
- Language of the publication
- English
- Date
- 2021-02-06
- Type
- Article
- Author(s)
- Szyszkowicz, Mieczysław
- de Angelis, Nicholas
- Publisher
- Springer
Abstract
To investigate the acute impact of various air pollutants on various disease groups in the urban area of the city of Toronto, Canada. Statistical models were developed to estimate the relative risk of an emergency department visit associated with ambient air pollution concentration levels. These models were generated for 8 air pollutants (lagged from 0 to 14 days) and for 18 strata (based on sex, age group, and season). Twelve disease groups extracted from the International Classification of Diseases 10th Revision (ICD-10) were used as health classifications in the models. The qualitative results were collected in matrices composed of 18 rows (strata) and 15 columns (lags) for each air pollutant and the 12 health classifications. The matrix cells were assigned a value of 1 if the association was positively statistically significant; otherwise, they were assigned to a value of 0. The constructed matrices were totalized separately for each air pollutant. The resulting matrices show qualitative associations for grouped diseases, air pollutants, and their corresponding lagged concentrations and indicate the frequency of statistically significant positive associations. The results are presented in colour-gradient matrices with the number of associations for every combination of patient strata, pollutant, and lag in corresponding cells. The highest number of the associations was 8 (of 12 possible) obtained for the same day exposure to carbon monoxide, nitrogen dioxide, and days with elevated air quality health index (AQHI) values. For carbon monoxide, the number of the associations decreases with the increasing lags. For this air pollutant, there were almost no associations after 8 days of lag. In the case of nitrogen dioxide, the associations persist even for longer lags. The numerical values obtained from the models are provided for every pollutant. The constructed matrices are a useful tool to analyze the impact of ambient air pollution concentrations on public health.
Plain language summary
Health Canada is responsible for conducting risk assessments on air pollution as part of the Addressing Air Pollution Horizontal Initiative. There is growing evidence suggesting that air pollution can contribute to a large spectrum of health problems. Health Canada carried out a study to examine whether air pollution concentration levels are associated with various health conditions. Results show that admissions to emergency departments for 12 different classes of diseases were related to air pollution levels on the day of admission and in two weeks preceding admission. The study found that air pollutants, notably carbon monoxide, nitrogen dioxide, particulate matter, and the air quality health index (AQHI), were associated with number of ED visit for amalgamated health problems, particularly in colder months. The results suggest that ambient air pollutants may contribute to emergency department visits for various health conditions, possibly reflecting acute impacts on human organs. These data add to the body of knowledge used in assessing population health impacts and in identifying vulnerable sub-populations.
Subject
- Health,
- Health and safety