Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data

Roger Morbey*, Gillian Smith, Karen Exley, André Charlett, Daniela de Angelis, Sally Harcourt, Felipe Gonzalez, Iain Lake, Alec Dobney, Alex Elliot

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Syndromic surveillance data were used to estimate the direct impact of air pollution on healthcare-seeking behaviour, between 1 April 2012 and 31 December 2017. A difference-in-differences approach was used to control for spatial and temporal variations that were not due to air pollution and a meta-analysis was conducted to combine estimates from different pollution periods. Significant increases were found in general practitioner (GP) out-of-hours consultations, including a 98% increase (2–386, 95% confidence interval) in acute bronchitis and a 16% (3–30) increase in National Health Service (NHS) 111 calls for eye problems. However, the numbers involved are small; for instance, roughly one extra acute bronchitis consultation in a local authority on a day when air quality is poor. These results provide additional information for healthcare planners on the impacts of localised poor air quality. However, further work is required to identify the separate impact of different pollutants.

Original languageEnglish
Article number7097
JournalInternational Journal of Environmental Research and Public Health
Volume19
Issue number12
DOIs
Publication statusPublished - 1 Jun 2022

Bibliographical note

Funding Information:
We acknowledge the UK Health Security Agency Real-time Syndromic Surveillance Team for technical expertise in delivering the daily syndromic service. We also thank syndromic data providers: NHS 111 and NHS Digital; Advanced and providers submitting data to the GP out-of-hours system; ED clinicians, NHS Trusts, and NHS Digital supporting EDSSS; participating TPP practices supporting GPs in hours; and ambulance trusts and the Association of the Ambulance Chief Executives.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • air pollution
  • epidemiology
  • health burden
  • public health
  • syndromic surveillance

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