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Research
Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
Hanne Krage Carlsen
University of Iceland
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1656-9624
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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: 215 000) 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-hour mean SO2>125µg/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.
Keywords
Volcanic eruption, atmospheric transport, respiratory disease, epidemiology, public health
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CURRENT STATUS: Under Review
Version 2
Posted 01 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 28 Dec, 2020
Reviewers invited
Invitations sent on 28 Dec, 2020
Reviewer #1 agreed
On 28 Dec, 2020
Review #1 received
Received 28 Dec, 2020
Editor assigned
On 18 Nov, 2020
Submission checks complete
On 18 Nov, 2020
Editor invited
On 18 Nov, 2020
No comments provided
Editorial decision: Major revision
On 20 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Review #2 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 28 Sep, 2020
Reviewer #1 agreed
On 28 Sep, 2020
Reviewer #2 agreed
On 28 Sep, 2020
Editor assigned
On 04 Sep, 2020
First submitted
On 03 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
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This preprint is under consideration at Environmental Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
Hanne Krage Carlsen
University of Iceland
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1656-9624
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 01 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 28 Dec, 2020
Reviewers invited
Invitations sent on 28 Dec, 2020
Reviewer #1 agreed
On 28 Dec, 2020
Review #1 received
Received 28 Dec, 2020
Editor assigned
On 18 Nov, 2020
Submission checks complete
On 18 Nov, 2020
Editor invited
On 18 Nov, 2020
No comments provided
Editorial decision: Major revision
On 20 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Review #2 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 28 Sep, 2020
Reviewer #1 agreed
On 28 Sep, 2020
Reviewer #2 agreed
On 28 Sep, 2020
Editor assigned
On 04 Sep, 2020
First submitted
On 03 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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: 215 000) 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-hour mean SO2>125µg/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.
Figure 1
Figure 2