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Health effects following the Eyjafjallajökull volcanic eruption: a cohort study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. (Arcum)
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 6Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The study aimed to determine whether exposure to a volcanic eruption was associated with increased prevalence of physical and/or mental symptoms.

DESIGN: Cohort, with non-exposed control group.

SETTING: Natural disasters like volcanic eruptions constitute a major public-health threat. The Icelandic volcano Eyjafjallajökull exposed residents in southern Iceland to continuous ash fall for more than 5 weeks in spring 2010. This study was conducted during November 2010-March 2011, 6-9 months after the Eyjafjallajökull eruption.

PARTICIPANTS: Adult (18-80 years of age) eruption-exposed South Icelanders (N=1148) and a control population of residents of Skagafjörður, North Iceland (N=510). The participation rate was 72%.

MAIN OUTCOME MEASURES: Physical symptoms in the previous year (chronic), in the previous month (recent), General Health Questionnaire (GHQ-12) measured psychological morbidity.

RESULTS: The likelihood of having symptoms during the last month was higher in the exposed population, such as; tightness in the chest (OR 2.5; 95% CI 1.1 to 5.8), cough (OR 2.6; 95% CI 1.7 to 3.9), phlegm (OR 2.1; 95% CI 1.3 to 3.2), eye irritation (OR 2.9; 95% CI 2.0 to 4.1) and psychological morbidity symptoms (OR 1.3; 95% CI 1.0 to 1.7). Respiratory symptoms during the last 12 months were also more common in the exposed population; cough (OR 2.2; 95% CI 1.6 to 2.9), dyspnoea (OR 1.6; 95% CI 1.1 to 2.3), although the prevalence of underlying asthma and heart disease was similar. Twice as many in the exposed population had two or more symptoms from nose, eyes or upper-respiratory tract (24% vs 13%, p<0.001); these individuals were also more likely to experience psychological morbidity (OR 4.7; 95% CI 3.4 to 6.5) compared with individuals with no symptoms. Most symptoms exhibited a dose-response pattern within the exposed population, corresponding to low, medium and high exposure to the eruption.

CONCLUSIONS: 6-9 months after the Eyjafjallajökull eruption, residents living in the exposed area, particularly those closest to the volcano, had markedly increased prevalence of various physical symptoms. A portion of the exposed population reported multiple symptoms and may be at risk for long-term physical and psychological morbidity. Studies of long-term consequences are therefore warranted.

Place, publisher, year, edition, pages
BMJ Publishing Group , 2012. Vol. 2, no 6
Keyword [en]
Epidemiology, Public health, Iceland; ash; hazards; dust; time
National Category
Environmental Health and Occupational Health
URN: urn:nbn:se:umu:diva-67368DOI: 10.1136/bmjopen-2012-001851ISI: 000315081400110PubMedID: 23144261OAI: diva2:611606
Available from: 2013-03-18 Created: 2013-03-18 Last updated: 2016-05-23Bibliographically approved
In thesis
1. Health effects of air pollution in Iceland: respiratory health in volcanic environments
Open this publication in new window or tab >>Health effects of air pollution in Iceland: respiratory health in volcanic environments
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Air pollution has adverse effects on human health. The respiratory system is the most exposed and short-term changes in air pollution levels have been associated with worsening of asthma symptoms and increased rates of heart attacks and stroke. Air pollution in cities due to traffic is the major concern, as many people are exposed. However, natural sources of air pollution such as natural dust storms and ash from volcanic eruptions can also compromise human health. Exposure to volcanic eruptions and other natural hazards can also threaten mental health. Air pollution has not been extensively studied in Iceland, in spite of the presence of several natural pollution sources and a sizeable car fleet in the capital area.

The aim of this thesis was to determine if there was a measurable effect on health which could be attributed to air pollution in Iceland. This aim was pursued along two paths; time series studies using register data aimed to determine the short-term association between daily variation in air pollution and on one hand daily dispensing of anti-asthma medication or the daily number of emergency room visits and emergency admissions for cardiopulmonary causes and stroke. The other method was to investigate if exposure to the Eyjafjallajökull volcanic eruption was associated with adverse health outcomes, either at the end of the eruption, or 6 months later.

In paper I time series regression was used to investigate the association between the daily number of individuals who were dispensed anti-asthma medication and levels of the air pollutants particle matter with an aerodynamic diameter less than 10 μm (PM10), nitrogen dioxide (NO2), ozone (O3), and hydrogen sulfide (H2S) during the preceding days. For the study period 2006-9, there were significant associations between the daily mean of PM10 and H2S and the sales of anti-asthma medication 3 to 5 days later. Giving the exposure as the highest daily one-hour mean gave more significant results. Air pollution negatively affected the respiratory health of asthma medication users, prompting them to refill their prescriptions before they had originally intended to.

In paper II the main outcome was the number of individuals seeking help at Landspitali University Hospital emergency room for cardiopulmonary disease or stroke. Time series regression was used to identify the lag that gave the best predictive power, and models were run for data for 2003-9 pollutants PM10, NO2, and O3. O3 was significantly associated with the number of emergency hospital visits the same day and two days later in all models, and both for men, women and the elderly. Only emergency hospital visits of the elderly were associated with NO2, and there were no associations with PM10.

In paper III the aim was to investigate if the health effects of PM10 were affected by the addition of volcanic ash from the 2010 eruption of Eyjafjallajökull and 2011 eruption of Grímsvötn to PM10 in the capital area. Time series regression of emergency hospital visits and PM10 before and after the Eyjafjallajökull eruption showed that the effect tended to be higher after the eruption, but the results were not significant. Analysis with a binary indicator for high levels of PM10 from volcanic ash and other sources showed that volcanic ash was associated with increased emergency hospital visits. There were no associations with high levels of PM10 from other sources.

In paper IV, the health of the population exposed to the ongoing eruption of Eyjafjallajökull in 2010 was investigated thoroughly. Lung function in adults was better than in a reference group from the capital area, though many reported sensory organ irritation symptoms and symptoms of stress and mental unhealth, especially those with underlying diseases.

Paper V report the results from a questionnaire study which was carried out six months after the Eyjafjallajökull eruption. The study population comprised a cohort of south Icelanders exposed to the eruption to varying degrees and a reference group from north Iceland. Respiratory and eye symptoms were much more common in south Icelanders than in the reference group, after adjusting for demographic characteristics. Mental unhealth rates had declined considerably.

In the studies, we found that urban air pollution and natural particles have short-term effects on anti-asthma medication dispensing and emergency room visits and hospital admissions. Exposure to natural particles in the form of volcanic dust was associated with increased respiratory symptoms in a very exposed population. There were indications that volcanic ash particles were associated with increased emergency hospital visits in the following days.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2014. 82 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1659
Respiratory health, air pollution, volcanic ash, epidemiology, hydrogen sulfide.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
urn:nbn:se:umu:diva-89153 (URN)978-91-7601-082-2 (ISBN)
Public defence
2014-06-13, Triple Helix, Samverkanshuset, Umeå Universitet, Umeå, 13:00 (English)

Statement of collaboration

This thesis and the work in it have been produced in collaboration between University of Iceland and Umeå University. The thesis was issued and defended at both institutions. Responsible

Available from: 2014-05-23 Created: 2014-05-23 Last updated: 2016-08-17Bibliographically approved

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