Does air pollution increase the effect of aeroallergens on hospitalization for asthma?

• Published in: Journal of allergy and clinical immunology 2012-01, Vol.129 (1), p.228-231
• Main Authors: Cakmak, Sabit, PhD, Dales, Robert E., MD, MSc, Coates, Frances, MLT
• Format: Article
• Language: English
• Subjects: Air Pollutants - analysis; Air Pollutants - chemistry; Air pollution; Air Pollution - adverse effects; allergens; Allergens - analysis; Allergens - chemistry; Allergy and Immunology; Asthma; Asthma - epidemiology; Asthma - etiology; Atmospheric pressure; Biological and medical sciences; Canada - epidemiology; Carbon monoxide; Chronic obstructive pulmonary disease, asthma; Cities; epidemiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Fungi; Hospitalization; Humans; Immunopathology; Maximum likelihood method; Medical sciences; Monitoring systems; Nitrogen dioxide; Outdoor air quality; Pneumology; Pollen - chemistry; Population; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Seasons; Statistical methods
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2011.09.025

Background Clinical experiments demonstrate that the asthmatic response to an aeroallergen can be enhanced by prior exposure to an air pollutant. Objective We sought to compare the effects of ambient aeroallergens on hospitalization for asthma between high and low air pollution days in 11 large Canadian cities. Methods Daily time-series analysis was used, and results were adjusted for day of the week, temperature, barometric pressure, and relative humidity. Results The relative risk of admission for an interquartile increase in tree pollen levels was 1.124 (95% CI, 1.101-1.147) on days of lower values of fine particulate matter with a median aerodynamic diameter less than or equal to 2.5 μm (PM2.5 ) compared with 1.179 (95% CI, 1.149-1.21) on days of higher PM2.5 values. Significant ( P ≤ .05) differences in the relative risks of admission between lower versus higher values of particulate matter with a median aerodynamic diameter less than or equal to 10 μm in diameter were 1.149 (95% CI, 1.118-1.181) versus 1.210 (95% CI, 1.161-1.261) for ascomycetes, 1.112 (95% CI, 1.085-1.14) versus 1.302 (95% CI, 1.242-1.364) for basidiomycetes, 1.159 (95% CI, 1.125-1.195) versus 1.149 (95% CI, 1.129-1.169) for deuteromycetes, and 1.061 (95% CI, 1.016-1.107) versus 1.117 (95% CI, 1.092-1.143) for weeds. Conclusion We identified an association between aeroallergens and hospitalizations for asthma, which was enhanced on days of higher air pollution. Minimizing exposure to air pollution might reduce allergic exacerbations of asthma.