The Journal of Allergy and Clinical Immunology
Volume 113, Issue 2 , Pages 303-306, February 2004

Influence of outdoor aeroallergens on hospitalization for asthma in Canada

  • Robert E. Dales, MD, MSc

      Affiliations

    • University of Ottawa, Ottawa, Ontario, Canada
    • Ottawa Health Research Institute, Ottawa, Ontario, Canada
    • Health Canada, Ottawa, Ontario, Canada
    • Corresponding Author InformationReprint requests: R. E. Dales, MD, MSc, The Ottawa Hospital (General Campus), 501 Smyth Rd, Box 211, Ottawa, Ontario, Canada K1H 8L6
  • ,
  • Sabit Cakmak, PhD

      Affiliations

    • Health Canada, Ottawa, Ontario, Canada
  • ,
  • Stan Judek, MSc

      Affiliations

    • Health Canada, Ottawa, Ontario, Canada
  • ,
  • Tom Dann, BESc, MEng

      Affiliations

    • Environment Canada, Ottawa, Ontario, Canada
  • ,
  • Frances Coates, MLT

      Affiliations

    • Aerobiology Research Laboratories, Ottawa, Ontario, Canada
  • ,
  • Jeffrey R. Brook, PhD

      Affiliations

    • Environment Canada, Ottawa, Ontario, Canada
  • ,
  • Richard T. Burnett, PhD

      Affiliations

    • Health Canada, Ottawa, Ontario, Canada

Received 24 June 2003; received in revised form 29 October 2003; accepted 17 November 2003.

Abstract 

Background

The risk of hospitalization for asthma caused by outdoor aeroallergens is largely unknown.

Objective

The objective of this study was to determine the association between changes in outdoor aeroallergens and hospitalizations for asthma from the Pacific coast to the Atlantic coast of Canada.

Methods

A daily time series analysis was done to test the association between daily changes in aeroallergens and daily changes in hospitalizations for asthma during a 7-year period between 1993 and 2000 in 10 of the largest cities in Canada. Results were adjusted for long-term trends, day of the week, climate, and air pollution.

Results

A daily increase, equivalent to the mean value of each allergen, was associated with the following percentage increase in asthma hospitalizations: 3.3% (95% CI, 2.3 to 4.1) for basidiomycetes, 3.1% (95% CI, 2.8 to 5.7) for ascomycetes, 3.2% (95% CI, 1.6 to 4.8) for deuteromycetes, 3.0% (95% CI, 1.1 to 4.9) for weeds, 2.9% (95% CI, 0.9 to 5.0) for trees, and 2.0% (95% CI, 1.1 to 2.8) for grasses. After accounting for the independent effects of trees and ozone, the combination of the 2 was associated with an additional 0.22% increase in admissions averaged across cities (P < .05).

Conclusion

These findings provide evidence for the hypothesis that aeroallergens are an important cause of severe asthma morbidity across Canada, and in some situations there might be a modest synergistic adverse effect of ozone and aeroallergens combined.

Keywords:  Asthma, fungus, pollen, air pollution, epidemiology

 

PII: S0091-6749(03)02678-2

doi:10.1016/j.jaci.2003.11.016

The Journal of Allergy and Clinical Immunology
Volume 113, Issue 2 , Pages 303-306, February 2004