Assessment of the relationship between chest diseases emergency service applications and air pollution

Introduction: Air pollution causes a decrease of respiratory functions in lungs and systemic circulation by means of lungs, respiratory tract infections, asthma and COPD development and an increase of inflammations. There is no study available in the literature exhibiting the relationship between air pollution in the province Ankara and lower respiratory tract emergency service applications. This study aims to evaluate the relationship between the ratio of pulmonary disease patients (asthma and COPD as well as pneumonia, bronchiectasis, interstitial lung diseases and pulmonary thromboembolia) applying to the emergency service with air pollution. Materials and Methods: The applications of patients suspected of primary pulmonary pathology as a result of Pulmonary Diseases consultation in the emergency service of Ankara Ataturk Training and Research Hospital between August 2018 and February 2019 were included to the study. Study population consisted of 302 patients. In the study, SO2, PM10 and PM2,5 were selected as indicators of air pollution. Daily data relating to the indicators were retrieved from website of Air Quality Monitoring Stations of T.R. Ministry of Environment and Urban Planning. In the study, demographical features, emergency service symptoms and diagnoses, artery blood gasses (pH, pCO2, pO2, sO2), complete blood count (hemoglobin and white blood cell), CRP and procalcitonin levels of the patients were examined. Results: During pulmonary diseases emergency service application, 11.6% of patients were diagnosed as asthma, 33.1% as COPD, 13.9% as PTE, 44.7% as pneumonia, 11.2% as bronchiectasis, 4% as interstitial AH, and 2% as lung cancer and 44.7% as obstructive AH. It was determined that 87.7% of patients presented with cough, 40.4% presented with sputum, 64.9% presented with dyspnea, 37.4% presented with chest pain, 6% presented with hemoptysis and 27.8% presented with other symptoms. It was also determined in consideration of emergency service applications that SO2 and PM10 levels from air polluter parameters were also at the highest levels. Air pollution parameter/parameters of patients with asthma, COPD, pneumonia and obstructive lung diseases was/were detected to be significantly higher than the other patient groups. Air pollution parameter/parameters of patients with cough, sputum, dyspnea and chest pain was/were detected to be significantly higher than the other patient groups. A positive correlation was detected between RDW and procalcitonin levels, and air pollution parameter/parameters. Conclusion: When air pollution increases, the number of applications to the emergency service due to pulmonary diseases increase as well, also demonstrating a correlation with the increase of particularly SO2, PM10 and PM2,5. It was determined that air pollution-based triggering factors triggered symptoms of patients and air pollution is an important factor for risk increase of COPD, asthma and pneumonia. Keywords: Air pollution, COPD, Pneumonia, SO2, PM10, PM2,5.