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

doi:10.3390/ijerph19127097

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

UK Health Security Agency

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

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 language	English
Article number	7097
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	12
DOIs	https://doi.org/10.3390/ijerph19127097
Publication status	Published - 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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/ijerph19127097

Cite this

Morbey, R., Smith, G., Exley, K., Charlett, A., de Angelis, D., Harcourt, S., Gonzalez, F., Lake, I., Dobney, A., & Elliot, A. (2022). Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data. International Journal of Environmental Research and Public Health, 19(12), Article 7097. https://doi.org/10.3390/ijerph19127097

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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: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

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Morbey, R, Smith, G, Exley, K , Charlett, A , de Angelis, D , Harcourt, S, Gonzalez, F, Lake, I, Dobney, A & Elliot, A 2022, 'Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data', International Journal of Environmental Research and Public Health, vol. 19, no. 12, 7097. https://doi.org/10.3390/ijerph19127097

Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data. / Morbey, Roger; Smith, Gillian; Exley, Karen et al.
In: International Journal of Environmental Research and Public Health, Vol. 19, No. 12, 7097, 01.06.2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data

AU - Morbey, Roger

AU - Smith, Gillian

AU - Exley, Karen

AU - Charlett, André

AU - de Angelis, Daniela

AU - Harcourt, Sally

AU - Gonzalez, Felipe

AU - Lake, Iain

AU - Dobney, Alec

AU - Elliot, Alex

N1 - 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.

PY - 2022/6/1

Y1 - 2022/6/1

N2 - 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.

AB - 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.

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DO - 10.3390/ijerph19127097

M3 - Article

C2 - 35742342

AN - SCOPUS:85131579500

SN - 1661-7827

VL - 19

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

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M1 - 7097

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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