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Air pollution and respiratory drug use in the city of Como, Italy

  • Respiratory Epidemiology
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Study objective and setting

Particulate air pollution has a known negative effect on human respiratory health, often studied with hospital admissions, emergency room access, or mortality as health indicators. We evaluate respiratory drug dispensing data as health indicators for the effects of total suspended particles (TSP) air pollution in the city of Como (84,713 inhabitants).

Design

Weekly count of individual patients with respiratory drug dispensed (Cases) and weekly dispensed daily defined doses (DDD) of drugs were modelled with weekly air mean concentrations of TSP using a Poisson regression model adjusted for long-term trends, seasonal variations, calendar variations due to holidays, and weather.

Main result

Relative risks (RR) were expressed for a variation from 10th to 90th percentile of TSP (29–92 μg/m3). Weekly aggregation was used in consideration of the complexity of drug dispensing data and potential biases of daily aggregation. For weekly mean concentrations of TSP, RR=1.082 (95% Confidence level (CI) 1.002–1.169) for Cases and RR=1.137 (95% CI 1.044–1.238) for DDD.

Conclusion

Our study concludes that both Cases and DDD of dispensed respiratory drugs could be useful for epidemiological surveillance of air pollutant health effects. Further investigation may routinely allow health and economics considerations, producing a stimulating new tool for health policy makers.

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References

  1. W Logan (1953) ArticleTitleMortality in London fog incident Lancet 1 336–338 Occurrence Handle10.1016/S0140-6736(53)91012-5 Occurrence Handle1:STN:280:CyyD3snlvFw%3D Occurrence Handle13012086

    Article  CAS  PubMed  Google Scholar 

  2. M Firket (1936) ArticleTitleFog along the Meuse Valley Trans Faraday Soc. 32 1192–1197 Occurrence Handle10.1039/tf9363201192 Occurrence Handle1:CAS:528:DyaA28XlsVehug%3D%3D

    Article  CAS  Google Scholar 

  3. H Shrenk H Heimann GD Clayton et al. (1949) Air pollution in Donora PA: epidemiology of the unusual smog episode of October 1948 Public Health Bulletin N °306, Public Health Service Washington, DC

    Google Scholar 

  4. HMPHS. Mortality and morbidity during the London fog of December 1952, in Public health and Medical subjects report. 1954

  5. InstitutionalAuthorNameWorld Health Organisation (1987) Air quality guidelines for Europe NumberInSeriesVol. n. 23. WHO Regional Publications European Series Copenhagen

    Google Scholar 

  6. T O’Riordan (1989) ArticleTitleAir pollution legislation and regulation in the European Community: A review essay Atmos Environ 23 293–306 Occurrence Handle10.1016/0004-6981(89)90578-7 Occurrence Handle1:CAS:528:DyaL1MXhvFyhu7c%3D

    Article  CAS  Google Scholar 

  7. B Brunekreef DW Dockery M. Krzyzanowski (1995) ArticleTitleEpidemiologic studies on short-term effects of low levels of major ambient air pollution components Environ Health Perspect 2 3–13

    Google Scholar 

  8. A Poncede Leon et al. (1996) ArticleTitleEffects of air pollution on daily hospital admissions for respiratory disease in London between 1987–1988 and 1991–1992 J Epidemiol Commun Health 50 IssueID1 S63–S70

    Google Scholar 

  9. W Dab et al. (1996) ArticleTitleShort-term respiratory health effects of ambient air pollution: results of the APHEA project in Paris J Epidemiol Commun Health 50 IssueID1 S42–S46

    Google Scholar 

  10. J Schwartz et al. (1996) ArticleTitleMethodological issues in studies of air pollution and daily counts of deaths or hospital admissions J Epidemiol Commun Health 50 IssueIDSuppl 1 S3–S11

    Google Scholar 

  11. K Katsouyanni et al. (1996) ArticleTitleShort-term effects of air pollution on health: A European approach using epidemiologic time series data: The APHEA protocol J Epidemiol Commun Health 50 IssueIDSuppl 1 S12–S18

    Google Scholar 

  12. K Katsouyanni et al. (7095) ArticleTitleShort-term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: Results from time series data from the APHEA project. Air Pollution and Health: A European Approach BMJ 1997 IssueID314 1658–1663

    Google Scholar 

  13. MA Vigotti et al. (1996) ArticleTitleShort-term effects of urban air pollution on respiratory health in Milan, Italy, 1980–1989 J Epidemiol Commun Health 50 IssueID1 S71–S75

    Google Scholar 

  14. RJ Delfino et al. (1997) ArticleTitleEffects of air pollution on emergency room visits for respiratory illnesses in Montreal, Quebec Am J Respir Crit Care Med 155 IssueID2 568–576 Occurrence Handle1:STN:280:ByiC1cvjvFA%3D Occurrence Handle9032196

    CAS  PubMed  Google Scholar 

  15. DM Mannino et al. (1996) ArticleTitleEmergency department visits and hospitalizations for respiratory disease on the island of Hawaii, 1981–1991 Hawaii Med J 55 IssueID3 48–54 Occurrence Handle1:STN:280:ByiD3snptVM%3D Occurrence Handle8882554

    CAS  PubMed  Google Scholar 

  16. Sunyer J, et al. Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. Am J Epidemiol 1991; 134(3): 277–286; discussion 287–289

    Google Scholar 

  17. JL Campbell RA. Elton (1994) ArticleTitleConsultation, waiting, prescribing and referral patterns: some methodological considerations Fam Pract 11 IssueID2 182–186 Occurrence Handle1:STN:280:ByqD2cjgsV0%3D Occurrence Handle7958584

    CAS  PubMed  Google Scholar 

  18. A Virji N. Britten (1991) ArticleTitleA study of the relationship between patients’ attitudes and doctors’ prescribing Fam Pract 8 IssueID4 314–319 Occurrence Handle1:STN:280:By2C1M3jslM%3D Occurrence Handle1800193

    CAS  PubMed  Google Scholar 

  19. C Janson et al. (1997) ArticleTitlePhysician-diagnosed asthma and drug utilization in the European Community Respiratory Health Survey Eur Respir J 10 IssueID8 1795–1802 Occurrence Handle1:STN:280:ByiH3MjlsVw%3D Occurrence Handle9272921

    CAS  PubMed  Google Scholar 

  20. InstitutionalAuthorNameBST. (1997) ArticleTitleB.T.S, Guidelines for COPD Thorax 52 IssueIDSuppl 5 S1–S28

    Google Scholar 

  21. WHO NN, Asthma management and prevention, global initiative for asthma. WHO, 1998

  22. AB Zeghnoun et al. (1999) ArticleTitleAir pollution and respiratory drug sales in the city of Le Havre, France, 1993–1996 Environ Res 81 224–230 Occurrence Handle1:CAS:528:DyaK1MXnt1Whsrw%3D Occurrence Handle10585018

    CAS  PubMed  Google Scholar 

  23. S Medina et al. (1996) ArticleTitleUrban air pollution is still a public health problem in Paris World Health Forum 17 IssueID2 187–193 Occurrence Handle1:STN:280:ByiD1M%2FjslU%3D Occurrence Handle8936279

    CAS  PubMed  Google Scholar 

  24. Index ED. Elsevier: New York, 1992

  25. M Pahor et al. (1994) ArticleTitleDrug data coding and analysis in epidemiologic studies Eur J Epidemiol 10 IssueID4 405–411 Occurrence Handle1:STN:280:ByqC2crmsFY%3D Occurrence Handle7843344

    CAS  PubMed  Google Scholar 

  26. C Rolle et al. (1995) ArticleTitleChange in prescribing patterns of general practitioners in Italy before and after the reform drug Act. A case study of changes in the city of Turin Pharm World Sci 17 IssueID5 158–162 Occurrence Handle1:STN:280:BymC3cflvVw%3D Occurrence Handle8574211

    CAS  PubMed  Google Scholar 

  27. FederFarma. Assistenza farmaceutica: Consumi in aumento. 1999; (http://www.federfarma.it)

  28. R Tamblyn et al. (1995) ArticleTitleThe use of prescription claims databases in pharmacoepidemiological research: The accuracy and comprehensiveness of the prescription claims database in Quebec J Clin Epidemiol 48 IssueID8 999–1009 Occurrence Handle1:STN:280:ByqB1MvmtVE%3D Occurrence Handle7775999

    CAS  PubMed  Google Scholar 

  29. D. Cappellá (1993) Descriptive tools and analysis, in Drug Utilisation Studies, Methods and Uses MNG Dukes (Eds) WHO Europe. WHO Copenhagen, Denmark 218

    Google Scholar 

  30. Stata Corp: LA.Stata 5, 2000, (http://www.stata.com)

  31. RL. Direzione Generale Sanità (1999) Salute e Ambiente in Lombardia (secondo Rapporto) Regione Lombardia Milano, Italy

    Google Scholar 

  32. CP. Bradley (1991) ArticleTitleDecision making and prescribing patterns – a literature review Fam Pract 8 IssueID3 276–287 Occurrence Handle1:STN:280:By2D2s%2FmsFM%3D Occurrence Handle1959729

    CAS  PubMed  Google Scholar 

  33. H Moolgavkar LG. (1996) ArticleTitleA critical review of the evidence on particulate air pollution and mortality Epidemiol 7 IssueID4 420–428 Occurrence Handle1:STN:280:BymA1crlt1I%3D

    CAS  Google Scholar 

  34. G Touloumi E Samoli K Katsouyanni (1996) ArticleTitleDaily mortality and ‘‘winter type’’ air pollution in Athens, Greece – a time series analysis within the APHEA project J Epidemiol Commun Health 50 IssueID1 S47–S51 Occurrence Handle10.1136/jech.50.Suppl_1.s47

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. London School of Hygiene and Tropical Medicine, Public Health and Policy, Keppel st, London, WC1E 7HT, UK

    Ferdinando E. Vegni, Beatrice Castelli, Francesco Auxilia & Paul Wilkinson

Authors
  1. Ferdinando E. Vegni
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  2. Beatrice Castelli
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  3. Francesco Auxilia
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  4. Paul Wilkinson
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Corresponding author

Correspondence to Ferdinando E. Vegni.

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Vegni, F.E., Castelli, B., Auxilia, F. et al. Air pollution and respiratory drug use in the city of Como, Italy. Eur J Epidemiol 20, 351–358 (2005). https://doi.org/10.1007/s10654-005-0243-4

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  • DOI: https://doi.org/10.1007/s10654-005-0243-4

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