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Pollen and asthma morbidity in Atlanta: A 26-year time-series study
Brooke L Lappe1, Stefanie Ebelt1, Rohan R D'Souza2
1Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Environment International
|June 8, 2023
Summary
Pollen exposure is linked to increased emergency department visits for asthma and wheeze, particularly from certain tree, weed, and grass pollens. These associations were stronger in Black and younger individuals and have lessened over time.
Area of Science:
- Environmental Health
- Epidemiology
- Allergy Research
Background:
- The link between environmental factors and asthma exacerbations is a critical public health concern.
- While some environmental risk factors for asthma are well-studied, the specific relationship between various pollen types and asthma requires further investigation.
- Understanding temporal trends and subgroup differences in pollen-asthma associations is essential for targeted interventions.
Purpose of the Study:
- To investigate the association between ambient pollen concentrations and emergency department (ED) visits for asthma and wheeze in Atlanta, Georgia.
- To examine how these associations vary by pollen type, decade, race, age, and insurance status.
- To analyze temporal changes in pollen-asthma relationships over a 26-year period.
Main Methods:
- Utilized time-series analyses with quasi-Poisson distributed lag models to assess ED visits for asthma/wheeze against speciated pollen data.
- Analyzed data from 1993-2018, incorporating 13 individual pollen taxa and controlling for meteorological and temporal factors.
- Examined effect modification by decade, race, age groups (5-17, 18-64, 65+), and insurance status (Medicaid vs. non-Medicaid).
Main Results:
- A total of 686,259 ED visits for asthma and wheeze were recorded between 1993 and 2018, showing an increasing trend.
- Positive associations were found between ED visits and nine pollen types: trees (maple, birch, pine, oak, willow, sycamore, mulberry), weeds (nettle, pigweed), and grasses.
- Rate ratios indicated a 1-8% increase in asthma/wheeze ED visits per standard deviation increase in pollen, with stronger associations observed in earlier years (1993-2000), younger individuals, and Black patients.
Conclusions:
- Specific pollen types, including certain trees, weeds, and grasses, are associated with increased emergency department visits for asthma and wheeze.
- The impact of pollen on asthma exacerbations appears more pronounced in Black and younger populations.
- Evidence suggests a temporal decrease in the strength of pollen-asthma associations over the study period.
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