title: Monitoring the effect of air pollution episodes on health care consultations and ambulance call-outs in England during March/April 2014: A retrospective observational analysis.
abstract: There is an increasing body of evidence illustrating the negative health effects of air pollution including increased risk of respiratory, cardiac and other morbid conditions. During March and April 2014 there were two air pollution episodes in England that occurred in close succession. We used national real-time syndromic surveillance systems, including general practitioner (GP) consultations, emergency department attendances, telehealth calls and ambulance dispatch calls to further understand the impact of these short term acute air pollution periods on the health seeking behaviour of the general public. Each air pollution period was comparable with respect to particulate matter concentrations (PM10 and PM2.5), however, the second period was longer in duration (6 days vs 3 days) and meteorologically driven 'Sahara dust' contributed to the pollution. Health surveillance data revealed a greater impact during the second period, with GP consultations, emergency department attendances and telehealth (NHS 111) calls increasing for asthma, wheeze and difficulty breathing indicators, particularly in patients aged 15-64 years. Across regions of England there was good agreement between air quality levels and health care seeking behaviour. The results further demonstrate the acute impact of short term air pollution episodes on public health and also illustrate the potential role of mass media reporting in escalating health care seeking behaviour.
authors.affiliation: Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham B3 2PW, UK. Electronic address: alex.elliot@phe.gov.uk.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Elliot
authors.affiliation: Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham B3 2PW, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Smith
authors.affiliation: Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Birmingham B3 2PW, UK.
authors.forename: Alec
authors.initials: A
authors.lastname: Dobney
authors.affiliation: Environmental Change Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: John
authors.initials: J
authors.lastname: Thornes
authors.affiliation: Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, Birmingham B3 2PW, UK.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Smith
authors.affiliation: Environmental Change Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Sotiris
authors.initials: S
authors.lastname: Vardoulakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D011159:Population Surveillance; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000393:Air Pollutants
keywords: Air pollution; Ambulance; Asthma; Syndromic surveillance; Wheeze