Emergency room visits for respiratory conditions in children increased after Guagua Pichincha volcanic eruptions in April 2000 in Quito, Ecuador observational study: time series analysis.
BACKGROUND
This study documented elevated rates of emergency room (ER) visits for acute upper and lower respiratory infections and asthma-related conditions in the children of Quito, Ecuador associated with the eruption of Guagua Pichincha in April of 2000.


METHODS
We abstracted 5169 (43% females) ER records with primary respiratory conditions treated from January 1-December 27, 2000 and examined the change in pediatric ER visits for respiratory conditions before, during, and after exposure events of April, 2000. We applied a Poisson regression model adapted to time series of cases for three non-overlapping disease categories: acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), and asthma-related conditions in boys and girls for three age groups: 0-4, 5-9, and 10-15 years.


RESULTS
At the main pediatric medical facility, the Baca Ortiz Pediatric Hospital, the rate of emergency room (ER) visits due to respiratory conditions substantially increased in the three weeks after eruption (RR = 2.22, 95%CI = [1.95, 2.52] and RR = 1.72 95%CI = [1.49, 1.97] for lower and upper respiratory tract infections respectively. The largest impact of eruptions on respiratory distress was observed in children younger than 5 years (RR = 2.21, 95%CI = [1.79, 2.73] and RR = 2.16 95%CI = [1.67, 2.76] in boys and girls respectively). The rate of asthma and asthma-related diagnosis doubled during the period of volcano fumarolic activity (RR = 1.97, 95%CI = [1.19, 3.24]). Overall, 28 days of volcanic activity and ash releases resulted in 345 (95%CI = [241, 460]) additional ER visits due to respiratory conditions.


CONCLUSIONS
The study has demonstrated strong relationship between ash exposure and respiratory effects in children.
Naumova
Elena N
EN
Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston MA 02111, USA. elena.naumova@tufts.edu
Yepes
Hugo
H
Griffiths
Jeffrey K
JK
Sempértegui
Fernando
F
Khurana
Gauri
G
Jagai
Jyotsna S
JS
Játiva
Edgar
E
Estrella
Bertha
B
D000293:Adolescent; D000367:Age Factors; D000397:Air Pollution / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004484:Ecuador / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016012:Poisson Distribution; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology; D018707:Volcanic Eruptions / Q000009:adverse effects*