Global request for healthcare: a tool to evaluate both, pollution and corrective action impacts.
To the editor
We have read with a great interest the analysis provided by Mr. Robin Russell-Jones.[1] As numerous scientific articles focus on effects of pollution on population's health, he promotes drastic actions aiming to decrease pollutants emission by transport vehicles, in particular diesel vehicles.[2] Some of those actions are targeted at limiting access to specific zones, such as urban or suburban ones. We completely agree with his conclusions. Nevertheless, most of the studies have focused on specific pollutant or disease, whereas pollution impact is, without any doubt, much larger. In addition, achieving all proposed recommendations, although essential, might take a long, long time. In the meantime, focusing only on pollutants concentration cutoffs (rarely respected, whatever the country) could be insufficient to forecast the go for exceptional corrective actions as speed or circulation limiting.
Our Center for the Reception and Regulation of Medical Calls (CRRMC) is situated in the northeastern part of Paris, in the 93rd department, a 236 km2 area inhabited by approximatively 1.6 million people. The aim of our CRRMC (SAMU 93) is to manage all medical calls, whatever their reason or level of severity, in the related area. The latter is characterized by a dense network of streets, roads and speedways, as many sources of pollutants from exhaust gases. Moreover, our geographical situation exposes us to Parisian emissions carried by the prevailing winds from west to east. Therefore, we wanted to determine whether indices able to forecast the need for exceptional actions as we previously described could be found.[3] We analyzed the relationship between air pollution levels (recorded and classified according to five levels by local authorities) and the number of calls. 639,576 calls were managed in a period of 1,134 consecutive days, from December 30, 2013 to February 5, 2017. The results showed that the number of calls was strongly correlated with air pollution levels (R2=0.9). The median number of calls was 564 (507-643) per day. It increased from 502 (494–621) to 650 (540–704) respectively during the days with the best (N=7) and the worst air quality (N=60).
Such a global analysis based on a large population, regardless of the pathology or its severity, shows a strong relationship between air pollution levels and the need for health care, including primary care. Thus, global request for healthcare can be a useful tool to evaluate or even forecast both, pollution as well as corrective action impacts on population's health.
References
1. Russell-Jones R. Air pollution in the UK: better ways to solve the problem. BMJ. 2017 Jun 14;357:j2713. PMID: 28615170
2. Anenberg SC, Miller J, Minjares R, Du L, Henze DK, Lacey F, Malley CS, Emberson L, Franco V, Klimont Z, Heyes C. Impacts and mitigation of excess diesel-related NOx emissions in 11 major vehicle markets. Nature. 2017 May 15
3. Lapostolle F, Fleury M, Crocheton N, Galinski M, Cupa M, Lapandry C, Adnet F. Determination of early markers of a sanitary event. The example of the heat wave of August 2003 at the Samu 93-centre 15 in France. Presse Med 2005;34:199-202
Rapid Response:
Global request for healthcare: a tool to evaluate both, pollution and corrective action impacts.
To the editor
We have read with a great interest the analysis provided by Mr. Robin Russell-Jones.[1] As numerous scientific articles focus on effects of pollution on population's health, he promotes drastic actions aiming to decrease pollutants emission by transport vehicles, in particular diesel vehicles.[2] Some of those actions are targeted at limiting access to specific zones, such as urban or suburban ones. We completely agree with his conclusions. Nevertheless, most of the studies have focused on specific pollutant or disease, whereas pollution impact is, without any doubt, much larger. In addition, achieving all proposed recommendations, although essential, might take a long, long time. In the meantime, focusing only on pollutants concentration cutoffs (rarely respected, whatever the country) could be insufficient to forecast the go for exceptional corrective actions as speed or circulation limiting.
Our Center for the Reception and Regulation of Medical Calls (CRRMC) is situated in the northeastern part of Paris, in the 93rd department, a 236 km2 area inhabited by approximatively 1.6 million people. The aim of our CRRMC (SAMU 93) is to manage all medical calls, whatever their reason or level of severity, in the related area. The latter is characterized by a dense network of streets, roads and speedways, as many sources of pollutants from exhaust gases. Moreover, our geographical situation exposes us to Parisian emissions carried by the prevailing winds from west to east. Therefore, we wanted to determine whether indices able to forecast the need for exceptional actions as we previously described could be found.[3] We analyzed the relationship between air pollution levels (recorded and classified according to five levels by local authorities) and the number of calls. 639,576 calls were managed in a period of 1,134 consecutive days, from December 30, 2013 to February 5, 2017. The results showed that the number of calls was strongly correlated with air pollution levels (R2=0.9). The median number of calls was 564 (507-643) per day. It increased from 502 (494–621) to 650 (540–704) respectively during the days with the best (N=7) and the worst air quality (N=60).
Such a global analysis based on a large population, regardless of the pathology or its severity, shows a strong relationship between air pollution levels and the need for health care, including primary care. Thus, global request for healthcare can be a useful tool to evaluate or even forecast both, pollution as well as corrective action impacts on population's health.
References
1. Russell-Jones R. Air pollution in the UK: better ways to solve the problem. BMJ. 2017 Jun 14;357:j2713. PMID: 28615170
2. Anenberg SC, Miller J, Minjares R, Du L, Henze DK, Lacey F, Malley CS, Emberson L, Franco V, Klimont Z, Heyes C. Impacts and mitigation of excess diesel-related NOx emissions in 11 major vehicle markets. Nature. 2017 May 15
3. Lapostolle F, Fleury M, Crocheton N, Galinski M, Cupa M, Lapandry C, Adnet F. Determination of early markers of a sanitary event. The example of the heat wave of August 2003 at the Samu 93-centre 15 in France. Presse Med 2005;34:199-202
Competing interests: No competing interests