Short-term associations between air pollution and sales of reimbursed respiratory drugs in Brussels.

Koen Simons, Ronald Buyl, Tim Nawrot, Danny Coomans, B. Nemery, An VAN NIEUWENHUYSE

Research output: Chapter in Book/Report/Conference proceedingMeeting abstract (Book)


Background: Ambient air pollution levels in Brussels (Belgium) remained relatively large throughout the last decade. Few health effect estimates have been made available.
Aim: To assess the impact of air pollution on anti-asthmatic, bronchodilator, and cold and cough medication sales in the Brussels Capital Region (approximately one million inhabitants).
Methods: Daily medication sales data for the WHO ATC-groups R3 (obstructive airway diseases) and R5 (cough and cold preparations) were obtained from the mandatory Belgian Health Insurance System. Population-weighted daily ambient concentrations of PM10, NO2, and SO2 were calculated by the RIO-CORINE interpolation technique for 4x4 km grid cells. Daily fluctuations in the classical confounders were taken into account. Ecological time series analyses in combination with Bayesian Model Averaging were carried out for a 7-year period (2005-2011) for each pollutant. Lags up to 10 days were included.
Results:1) For R3, R5, and the short-acting bronchodilators results were significant for the ages 0-75+. Increases of 10 µg/m3 of PM10, NO2 and SO2 were associated with a 1%, 2% and 10-20% increase in sales, respectively. For PM10 and NO2, significant increased risks were observed especially on the first day of the air pollution episode and again after a lag of 5-7 days. In contrast, for SO2 a quasi linear increase with increasing lags was observed. 2) Associations were the strongest for the age groups between 15-39 and 40-64 years, i.e. the age ranges of the economically active population. 3) For children (0-14 years), all risk estimates were above one. ForR3 and the SABA, results were significant for NO2 and SO2, and borderline not significant for PM10. For R5, the number of prescribed medication in this age category was very low.
Conclusion: This study suggests an increased sales of respiratory medication in relation to the current ambient air pollution levels in Brussels.
Original languageEnglish
Title of host publicationISEE Europe
Subtitle of host publication1st Young Researchers Conference on Environmental Epidemiology
Publication statusPublished - 22 Oct 2014
Event1st Young Researchers Conference on Environmental Epidemiology - ISEE Europe - Barcelona, Spain
Duration: 20 Oct 201421 Oct 2014


Conference1st Young Researchers Conference on Environmental Epidemiology - ISEE Europe

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