Hajat, Shakoor; (2002) Effects of air pollution on daily general practitioner consultations in London. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Few published studies have looked at the effects of air pollution on health in the primary care setting. As part of a large study to examine the association between air pollution and a number of health outcomes, this thesis investigates the relationship between daily GP consultations for respiratory and cardiovascular diseases and air pollution in London. Time- series analysis of daily numbers of GP consultations, controlling for time-trends, seasonal factors, day-of-week and holiday effects, influenza, weather, pollen levels and serial correlation, was conducted using data from registered patients in 45-47 London practices contributing to the General Practice Research Database during 1992-1994. The results suggested a reasonably consistent positive association of most pollutants tested with asthma consultation numbers. Seasonal analyses suggested that the strongest associations with asthma consultations were mostly occurring in months April-September. For other kinds of lower respiratory diseases, particulate matter, sulphur dioxide and nitrogen dioxide seemed to be the pollutants most consistently associated with an increase in consultations. A consistent negative association of ozone was observed with consultations for asthma and other lower respiratory diseases. Sulphur dioxide was the pollutant most strongly associated with an increased risk of consulting with allergic rhinitis or other upper respiratory complaints. No consistent associations were observed with air pollution and consultations for cardiovascular disease. In conclusion, the results presented in this thesis suggest an acute effect of air pollution on respiratory and allergic disease at levels well below current Government guidelines. Effects were generally found to be quite small, but the public health impact could be considerable due to the large number of patient contacts with GPs.

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