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Air pollution leads to millions of hospital visits for asthma attacks worldwide

Posted on 26 October 2018

Air pollution could be to blame for up to 33 million emergency asthma attack visits to hospital a year, a world study involving the University of York has found.

It is the first study to estimate the impact of air pollution on asthma cases across the globe.

Asthma is the most prevalent chronic respiratory disease worldwide, affecting about 358 million people.  The new findings, published in the journal Environmental Health Perspectives, suggests car emissions and other types of pollution may be a significant source of serious asthma attacks.

Non-fatal diseases

Dr Johan Kuylenstierna, co-author and Policy Director or the Stockholm Environment Institute (SEI)  based at York, said: “This is the first global study of the potential impacts of air pollution on serious asthma attacks that cause people to visit emergency rooms in hospitals around the world.

“Previous research by SEI and others have emphasised the impacts of air pollution on the number of premature deaths, but many more people are affected by poor health, through impacts of non-fatal diseases.”

The international, multi-institutional research team included scientists from the George Washington University Milken Institute School of Public Health, the University of Colorado Boulder, the Stockholm Environment Institute, the National Aeronautics and Space Administration (NASA), the Japan Agency for Marine-Earth Science and Technology, the Norwegian Meteorological Institute.

Key findings include:

• Nine to 23 million annual asthma emergency room (ER) visits globally (8 to 20 percent of total global asthma ER visits) may be triggered by ozone, a pollutant generated when car, power plant and other types of emissions interact with sunlight.
• Five to 10 million asthma emergency room visits every year (4 to 9 percent of total global asthma ER visits) were linked to fine particulate matter, small particles of pollution that can lodge deep in the lung’s airway tubes.
• About half of the asthma emergency room visits attributed to dirty air were estimated to occur in South and East Asian countries, notably India and China.
• Although the air in the United States is relatively clean compared to South and East Asian countries, ozone and particulate matter were estimated to contribute 8 to 21 percent and 3 to 11 percent of asthma ER visits in the United States, respectively.

Unsafe air

To estimate the global levels of pollution for this study, the researchers turned to atmospheric models, ground monitors and satellites equipped with remote-sensing devices.

Approximately 95 percent of the world’s population lives in places with unsafe air. Previously, the Global Burden of Disease Study focused on quantifying the impacts of air pollution on heart disease, chronic respiratory disease, lung cancer, and lower respiratory infections – finding that fine particulate matter and ozone were associated with 4.1 million and 230,000 premature deaths in 2016, respectively.

The research team say one way to reduce pollutants quickly would be to target emissions from cars, especially in big cities. Such policies would not only help people with asthma and other respiratory diseases, but it would help everyone breathe a little easier.

Global burden

“SEI were co-investigators and helped to initiate the research, highlighting the possibilities of performing a global study, further quantifying the air pollution impacts on health. It’s important to note that this study shows the most severe cases of asthma, so the real impact from air pollution on asthma might be even higher,” added Chris Malley, co-author and SEI Research Fellow at the University of York.

Susan C. Anenberg, lead author of the study and an Associate Professor of Environmental and Occupational Health at the George Washington University Milken Institute School of Public Health, said: “Millions of people worldwide have to go to emergency rooms for asthma attacks every year because they are breathing dirty air.”  

“Our findings suggest that policies aimed at cleaning up the air can reduce the global burden of asthma and improve respiratory health around the world.”

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