Association of outdoor air pollution and chronic respiratory morbidity in a town of northern India

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Association of outdoor air pollution and chronic
respiratory morbidity in a town of northern India
Rajesh Kumar, Manoj Sharma, Ashok Srivastva,
J.S.Thakur, H.K. Parwana, S.K.
Jindal Deptt. of Community Medicine and
Pulmonary Medicine, PGIMER,
Chandigarh, Punjab Pollution Control Board,
Patiala
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Broad Objective The study was aimed to evaluate
effects of outdoor air pollution on chronic
respiratory morbidity.

• Specific Objectives
• To monitor ambient air quality.
• To estimate the prevalence of respiratory
• morbidity and lung functions.
• To determine association between air pollution
  and chronic respiratory morbidity.

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Study Area 
Mandi Gobindgarh
Morinda
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Material And Methods

• Study Design-Cross-sectional study
• Study period- 2000-2001
• Sampling method- Cluster sampling
• Random selection of first household and
  then next nearest household.
• Sample size Total -4000
• Study area-2000
• Reference area-
  2000
• Sampling site-
• Mandi Gobindgarh 1. Guru ki Nagri
  2. Prem Nagar
  
• Morinda 1. Rest House
  Colony 2. Purana Bazar

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Study Tools

• Questionnaire
• Respiratory symptoms and diseases, SES
  (Kuppuswami
• scale), Household environment, Smoking history,
• Occupational history
• Physical Examination
• Height (cm.), Weight (kg.), Spirometery by
  portable
• Ventilometer (FVC, FEV1, PEFR, FEV1/FVC)
• Exposure Monitoring
• Air Sampling-weekly for two years
• High Volume Air Sampler-Twelve hourly- SPM, NOx,
  SOx, O3
• Organic Vapors Sampler- Eight hourly- CO
  
• Meterological data
• Wind velocity, Temperature and humidity

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Statistical Analysis

• Concentration of SPM, PM10(?g/m3) SOx, NOx, CO
  and O3 was summarised as means and standard
  deviation.
• Prevalence of respiratory symptoms spirometric
  airflow limitation
• Chi-square test
• Students t-test
• Logistic regression analysis
• Interaction between the air pollution and smoking
  was also included in the models.

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Annual Averages of SPM, NOx and SOx in Mandi
Gobindgarh
Pollutants (?g/m3)

• The data collected by the pollution control board
  shows that the quality of the ambient air in the
  study town was poor for a numbers of years and
  most of the migrant workers had resided in the
  town for considerable period of time.

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Participation rate of study subjects in study and
reference town
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Air Pollution Levels
Plt0.05
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Socio-demographic and life style characteristics
of study population
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Prevalence of Respiratory Symptoms
Morinda
Mandi Gobindgarh

• MALES

• FEMALES

Plt0.05
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Prevalence (per 100) of Spirometric defects
Plt0.05
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Association between air pollution and chronic
respiratory symptoms and spirometric airflow
limitation
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Summary

• High level of SPM in study town.
• Chronic respiratory morbidity was higher in the
  study town.
• Smoking, Non-LPG fuel users, Inadequate lighting,
  Inadequate Ventilation, Dampness and Occupational
  dust exposure was higher but SES was lower in
  study town.
• Logistic regression analysis reveled that high
  SPM level is responsible for higher respiratory
  morbidity even after controlling the effect of
  age, sex, SES, Smoking, Non-LPG fuel, Inadequate
  lighting and ventilation, Dampness, Occupational
  dust exposure.
• Conclusion
• It is concluded that people of Mandi Gobindgarh,
  which had quite high SPM level, have
  significantly more symptoms of cough, phlegm,
  dysponea, wheeze and obstructive defects as
  compared to Morinda which had all air pollutants
  below permissible level.

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