D2.397 - Air Pollution and Respiratory Health: A Regression Analysis of Asthma and Upper Respiratory Infections

Air pollution is a known risk factor for respiratory diseases, yet its specific role in different respiratory conditions remains unclear. This study investigates the associations between major air pollutants and Emergency Department (ED) admissions for asthma and upper respiratory infections (URTIs).

The data for this study was collected retrospectively. The dataset includes information on 1829 children who were admitted to ED between 2015 and spring of 2020 due to URTI (J00-J06 according to ICD-10) or asthma (J45.0, J45.1). The data was analyzed in relation to information from the State Environmental Monitoring, which measures environmental pollutants: suspended dust (PM10 with particle diameters up to 10 µm and PM2.5 up to 2.5 µm), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3). A linear regression analysis was conducted assessing the effects of PM2.5, PM10, NO₂, NOx, CO, SO₂, O₃, and seasonal variation on hospital admissions for recognitions J45.0, J45.1, and J00-J06. Model performance was evaluated using R² values and statistical significance (p < 0.05).

For J45.1 (non-allergic asthma), significant associations were observed with CO (β = 0.04299, p = 0.001), season (β = -0.00463, p = 0.001). Higher CO levels correlated with increased J45.1 events. The model explained 1.51% of the variance (R² = 0.0151, p = 0.0005). For allergic asthma J45.0 no significant associations were found between air pollutants and hospital admissions (all p-values > 0.16). The model had low explanatory power (R² = 0.0025, p = 0.7957). For upper respiratory infections (J00-J06), strong seasonal effects were detected (β = 0.320, p < 0.001), with higher admissions in specific seasons. CO (β = 1.116, p = 0.008) and SO₂ (β = 0.0547, p = 0.002) were also significantly associated with increased hospitalizations. However, PM2.5, PM10, NO₂, NOx, and O₃ did not show significant effects. The model explained 5.86% of the variance (R² = 0.0586, p < 0.001).

Our findings suggest that CO exposure is a significant risk factor for both asthma exacerbations and URTI, while SO₂ also contributes to upper respiratory morbidity. Seasonal variation plays a key role in upper respiratory infections and asthma. Further studies are needed to explore these associations in greater detail, incorporating additional environmental, however, appropriate environmental pollution prevention strategies should be intensified right now.