Associations between Pollen Counts, Pollutants, and Asthma-Related Hospital Admissions in a High-Density Indian Metropolis

Abstract

Background. The seasonal pattern of asthma-related hospitalization has often been correlated with ambient allergen/pollutant levels. Objective. To examine the relationship between asthma-related hospital admissions (ARHA) and outdoor pollen, spore, and pollutant levels for adult patients in a densely populated Indian megacity Kolkata. Methods. ARHA data were obtained from two major teaching hospitals of the city. Pollen and spores causing allergic sensitization were identified by skin prick tests (SPTs) among respiratory allergic subjects (N = 1353). Outdoor concentrations of aeroallergens were determined using a Burkard sampler for five consecutive years (2004–2009). Levels of NO₂, SO₂, suspended particulate matters (SPMs), and respirable particulate matters (RPMs) were made available by West Bengal Pollution Control Board (WBPCB, Government of West Bengal). Poisson multivariate Poisson regression (with adjustments for overdispersion) was used to model the data. Results. We found that ARHA in Kolkata increased with predictable regularity in March and September, while remaining low in January and July. SPT showed highly positive skin reactions with grass/weed and palm pollens in respiratory allergic patients, while Aspergilli spores also evoked good sensitivity. In our regression model, the airborne pollen types, Cheno-Amaranthaceae and Cyperaceae, and the inorganic pollutant, SO₂ and RPM, were significantly associated with ARHA (p < .05).

Conclusion. ARHA in the megacity of Kolkata shows two seasonal peaks that can be correlated with outdoor grass/weed pollen and RPM concentrations. In contrast, the city’s ambient fungal spore counts were not found to be significantly associated.

• asthma
• hospital admissions
• molds
• pollen
• pollutants

Acknowledgments

The authors are thankful to Amy Holler (Department of Internal Medicine, University of Cincinnati College of Medicine) for critically reviewing the manuscript and to West Bengal Pollution Control Board, Govt. of India, for providing air-pollution data.

Declaration of Interest

The authors have no conflicts of interest to report. The authors alone are responsible for the content and writing of this paper. PC was supported by CSIR, Government of India.