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Multicenter Study
. 2019 Aug 6:14:1763-1768.
doi: 10.2147/COPD.S208108. eCollection 2019.

Extreme desert dust storms and COPD morbidity on the island of Crete

Christina Lorentzou  1 , Giorgos Kouvarakis  2 , Georgios V Kozyrakis  3 , Nikolaos A Kampanis  3 , Irene Trahanatzi  4 , Othon Fraidakis  4 , Nikolaos Tzanakis  5 , Maria Kanakidou  2 , Panagiotis Agouridakis  1 , George Notas  1   3
Affiliations
Multicenter Study

Extreme desert dust storms and COPD morbidity on the island of Crete

Christina Lorentzou et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Introduction and objectives: Short-term extreme increases in desert-derived particulate-matter with aerodynamic diameter below 10 μm (PM10) may affect emergency department (ED) visits due to COPD exacerbations.

Research question: Our aim was to identify the effect of extreme increases in desert-derived PM10 on ED visits for dyspnea and COPD exacerbations and on the related hospital admissions.

Methods: We performed a retrospective analysis of dyspnea-related ED visits and hospital admissions in Heraklion, Crete, during four consecutive storms of desert-derived PM10 that happened during March 2018. We collected data from over 17,000 ED visits and recorded patients with atopic symptoms, COPD exacerbations, and dyspnea, as well as admissions to the departments of pulmonary medicine, internal medicine, and cardiology. PM10 data were collected from a monitoring station in the same geographic area.

Results: Four desert dust storms were recorded during the study period with 238, 203, 1138, and 310 μg/m3 average-daily PM10 and 652, 308, 4262, and 778 μg/m3 hourly mean day-peak PM10, respectively. There was no clinically important increase in total ED visits, total admissions or admissions to the departments of cardiology, pulmonary medicine, or internal medicine, during PM10 peaks. However, during the desert dust storm with daily-average PM10 above 500 μg/m3, there was a striking increase in dyspnea-related ED visits (including COPD exacerbations, 3.6-fold increase), while there was no clinically important increase in non-asthma allergy-related ED visits.

Conclusion: Extreme desert dust storm episodes may cause meaningful increases in ED visits for dyspnea and COPD exacerbations/admissions.

Keywords: COPD; desert dust storms; emergency department overcrowding; particulate-matter.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Monthly mean of PM10 aerosols in Heraklion, Crete from January to May for the years 2016–2018. Values represent the monthly mean (μg/m3) + standard deviation.
Figure 2
Figure 2
(A) Particulate matter with aerodynamic diameter below 10 μm (PM10) daily average and hourly mean day maximum during March 2018 in the geographic area of Heraklion. (B) Admissions to the departments of internal medicine (Int Med), cardiology (Cardio) and pulmonary (Pulmo) medicine during March 2018. (C) Total emergency department (ED) visits in Heraklion during the study period. (D) ED cases with dyspnea and COPD admissions at the University Hospital of Heraklion during the study period. We did not identify any increases in the studied parameters the days ensuing a desert dust storm.
See this image and copyright information in PMC

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