title: Climatic variables are associated with seasonal acute asthma admissions to accident and emergency room facilities in Trinidad, West Indies.
abstract: OBJECTIVE
  To determine if there is seasonal variation in acute asthmatic visits to accident and emergency (A&E) facilities in Trinidad and to identify the climatic variables associated with such visits.
  
  
  METHODS
  A retrospective census of patients with asthma, defined as those who required emergency bronchodilator nebulization, was taken at two A&E facilities in Trinidad from 1 January 1997 to 31 December 1999. The study included patients aged 64 years and under. Patient demographic data were obtained from the A&E records. Climate variables were taken from the island's sole Meteorological Office. Multiple regression was used to identify climate variables that were independent predictors of A&E asthma visits.
  
  
  RESULTS
  There were a total of 45 842 asthma admissions to the two facilities during the study period. Visits exhibited a cyclic pattern over the 3 years that varied according to the island's dry (January-May) and wet (June-December) seasons. There were more visits during the wet season than the dry (40 [SD=2] vs. 32 [SD=2] visits/day; P<0.001). The results of multiple regression indicated that season (P<0.001), barometric pressure (P<0.001), temperature difference (P<0.001), minimum temperature2 (P<0.001) and wind speed2 (P=0.032) were predictors of paediatric visits. Independent predictors of adult visits were season (P<0.001), relative humidity (P<0.001), minimum temperature (P=0.01), temperature difference2 (P<0.001) and minimum temperature2 (P=0.004). Season and climatic variables explained 18% of the variance of the total A&E asthma admissions.
  
  
  CONCLUSIONS
  There is seasonal variation in acute asthma visits to A&E facilities in Trinidad, which remains significant after controlling for climate variables. However, while climate has a role, there are other factors that may also be responsible for increased visits during the wet season. More research is needed to identify these factors.
authors: Department of Para-Clinical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago. iveymars@carec.paho.org
authors: M A
authors: MA
authors: Ivey
authors: D T
authors: DT
authors: Simeon
authors: M A
authors: MA
authors: Monteil
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D014300:Trinidad and Tobago / Q000453:epidemiology; D014887:Weather