Relationship between air quality and asthma-related emergency hospital admissions in Mexico City 2017-2019

Thorax. 2023 Dec 15;79(1):43-49. doi: 10.1136/thorax-2022-219262.

Abstract

Background: Previous studies found exposure to air pollution leads to exacerbations of asthma in paediatric and adult patients and increases asthma-related emergency hospital admissions (AREHA).

Methods: AREHAs and levels of air pollutants (PM10, PM2.5 and NO2) were obtained from Mexico City for the period 2017-2019. A time-series approach was used to explore the relationship between air pollutants and AREHA. Relative risks of AREHA were estimated using a negative binomial regression in young children (less than 5 years) and adults (greater than 18 years).

Results: There was a positive association between AREHA and PM10, PM2.5 and NO2 in adults, which remained after mutual adjustment for these pollutants. The relative risk (RR) of admission in adults increased by 3% (95% CI 1% to 4%) for a 10 µg/m3 increase in PM10, 1% (0.03% to 3%) for a 5 µg/m3 increase in PM2.5 and by 1% (0.06% to 2%) for a 5 µg/m3 increase in NO2. In contrast, in young children, AREHAs were negatively associated with PM10 after adjustment for NO2 (RR 0.97 (0.95 to 0.99) for a 10 µg/m3 and with NO2 after adjustment for PM10 and PM2.5 (RR 0.98 (0.96 to 0.99) and 0.97 (0.96 to 0.99), respectively, for a 5 µg/m3 increase in NO2). AREHAs in children were not associated with PM2.5 after adjustment for NO2.

Conclusions: Ambient air pollution, within the previous week, was associated with emergency hospital admissions for asthma to public hospitals in adults in Mexico City. The relationship in children was less consistent. Further work is needed to explore why differences between adults and children exist to inform appropriate interventions to benefit public health.

Keywords: Asthma.

MeSH terms

  • Adult
  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Asthma* / epidemiology
  • Asthma* / etiology
  • Child
  • Child, Preschool
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Hospitals
  • Humans
  • Mexico / epidemiology
  • Nitrogen Dioxide / adverse effects
  • Nitrogen Dioxide / analysis
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis

Substances

  • Nitrogen Dioxide
  • Air Pollutants
  • Particulate Matter