Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
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.
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Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
Posted 01 Dec, 2020
On 28 Dec, 2020
Invitations sent on 28 Dec, 2020
On 28 Dec, 2020
Received 28 Dec, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 18 Nov, 2020
On 20 Oct, 2020
Received 14 Oct, 2020
Received 14 Oct, 2020
Invitations sent on 28 Sep, 2020
On 28 Sep, 2020
On 28 Sep, 2020
On 04 Sep, 2020
On 03 Sep, 2020
On 03 Sep, 2020
On 03 Sep, 2020
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