Drug consumption and air pollution: an overview

Purpose Acute respiratory symptoms are among the health effects of air pollution exposure. Studies over the past decades have linked respiratory drug use (consumption or sales) with changes in air pollution conditions. Methods Twenty-one studies were analyzed to discuss whether increased levels of air pollution are associated with the use of medications for respiratory diseases. Results Epidemiological studies agree that variation in the drug use is related to air pollution exposure. In panel studies, although asthmatics are more sensitive to air pollution effects, the increase in drug use was comparable and similar to non-asthmatics. Ecological studies confirm a significant association in respiratory drug sales depending on the selected lags (that is the time elapsing between air pollution measurement and the resulting drug use). The results of a meta-analysis of two ecological studies showed an increase in risk for increase in daily mean concentration of some pollutant (10 mu g m(-3)). For Black Smoke RR = 1.007 (95% CI 1.004-1.011) for lag 1, and RR = 1.008 (95% CI 1.005-1.010) for lag 8. For Nitrogen dioxide, RR = 1.008 (95% CI 1.005-1.012) for lag 8 and for Sulfur dioxide, RR = 1.005 (95% CI 1.001-1.010) for lag 9. Conclusions The analysis of drug use provides useful data for the evaluation of risks which derive from exposure to air pollution. More studies are needed to measure the effects of air pollution on respiratory medication use. Lags of up to 14 days have to be considered and the pollutants to be considered should include particulate matter and ozone. Copyright (C) 2010 John Wiley & Sons, Ltd.