Short-term effects of air pollution on exacerbations of allergic asthma in Uzice region, Serbia

Introduction: Many time-series studies have shown a positive association between air pollution and asthma exacerbation. However, till now only one study in Serbia has examined this relationship. Aim: To examine the associations between air pollution and asthma emergency department (ED) visits in the Uzice region, Serbia. Material and methods: A time-stratified case-crossover design was applied to 424 ED visits for asthma exacerbation that occurred in the Uzice region, Serbia, in 2012-2014. Data about ED visits were routinely collected in the Uzice Health Centre. The daily average concentrations of particulate matter (PM2.5 and PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and black carbon (BC) were measured by automatic ambient air quality monitoring stations. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity and air pressure). Results: Statistically significant associations were observed between ED visits for asthma and 3-day lagged exposure to BC (OR = 3.23; 95% CI: 1.05-9.95), and between ED visits for asthma with coexisting allergic rhinitis and 0-day lag exposure to NO2 (OR = 1.57; 95% CI: 0.94-2.65), 2-day lag exposure to SO2 (OR = 1.97; 95% CI: 1.02-3.80), and 3-day lag exposure to PM10 (OR = 2.38; 95% CI: 1.17-4.84). Conclusions: Exposure to ambient air pollution in the Uzice region increases the risk of ED visits for asthma, particularly during the heating season.