Air pollution and emergency department visits for urticaria

Original Article, Pol J Public Health 2021;131: 67-70

Mieczysław Szyszkowicz1, Nicholas de Angelis

1 Environmental Health Centre: Environmental Health, Science and Research Bureau, Canada, Ottawa, Canada
2 Biomedical Program, Department of Mechanical and Aerospace Engineering, Carleton University, Ottawa, Canada

DOI_disc_logo 10.2478/pjph-2021-0013

© 2021 Medical University of Lublin. This is an open access article distributed under the Creative Commons Attribution-NonComercial-No Derivs licence (


Introduction. This study investigates associations between air pollution and emergency department (ED) visits for urticaria in Toronto, Canada.

Aim. To verify the hypothesis that urticaria are related to air pollution.

Material and methods. The National Ambulatory Care Reporting System database is used to draw the daily ED visits. The L50 section of the International Classification of Disease 10th Revision is applied to extract ED visits whose primary causes was urticaria-related skin condition. Statistical models (condition Poisson regression) using daily counts of ED visits are constructed for urticaria (health response) with ambient air pollution concentrations and weather factors as independent variable. Two air quality health indexes and six ambient air pollutants: fine particulate matter PM2.5, O3, CO, NO2, SO2, and maximum 8-hour average ozone are considered as an exposure.

Results. A total of 176 statistically significant (P-Value <0.05) positive correlations were identified over the 15 day lag period (0-14 days). For daily average of ambient ozone, 74 positive correlations were observed with the following relative risks (RR) for a one interquartile range (IQR=12.8 ppb) increase: RR=1.361 (95% confidence interval: 1.302, 1.404), 1.359 (1.299, 1.401), 1.351 (1.281, 1.404) in the warm season (April-September), lag 0, and RR=1.019 (1.013, 1.025), 1.023 (1.016, 1.030), 1.014 (1.007, 1.021), lag 1, in the cold period (October-March), for all, females, and males, respectively. 10, 45 and 45 positive correlations were also obtained for sulfur dioxide, fine particulate matter, and daily maximum 8-hour average ozone concentrations, respectively.

Conclusions. The results indicate that urban ambient air pollution could influence the numbers of ED visits for urticaria. Ambient ozone was determined as the main environmental factor contributing to these associations.

Keywords: air pollution; concentration; counts; urban; sex; skin.

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