Evaluation of the Impact of Black Carbon on the Worsening of Allergic Respiratory Diseases in the Region of Western Serbia: A Time-Stratified Case-Crossover Study

Abstract

Background and Objectives: Many epidemiological studies have shown a positive association between black carbon (BC) and the exacerbation of allergic rhinitis and allergic asthma. However, none of the studies in Serbia examined this relationship yet. The aim of this study was to examine the associations between BC and emergency department (ED) visits for allergic rhinitis and allergic asthma in the Užice region of Serbia. Materials and Methods: A time-stratified case-crossover design was applied to 523 ED visits for allergic rhinitis and asthma exacerbation that occurred in the Užice region of Serbia between 2012-2014. Data regarding ED visits were routinely collected in the Health Center of Užice. The daily average concentrations of BC were measured by automatic ambient air quality monitoring stations. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) 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 allergic rhinitis and 2-day lagged exposure to BC (OR = 3.20; CI = 1.00-10.18; p = 0.049) and allergic asthma and 3-day lagged exposure to BC (OR = 3.23; CI = 1.05-9.95; p = 0.041). Conclusion: Exposure to BC in the Užice region increases the risk of ED visits for allergic rhinitis and asthma, particularly during the heating season.

Keywords: Serbia; allergic asthma; allergic rhinitis; black carbon; case-crossover design; emergency department visits.

Figure 1

Polar diagram of BC concentration in the air according to months in Užice region, Serbia (from July 2012 to June 2014).

Figure 2

Mean values of BC concentration (µg/m³) according to the heating season in Užice region, Serbia (2012–2014).