Dust Storms and Emergency Department Visits in 3 Southwestern States Using NWS Storm Reports

Abstract

Importance: Dust storms are projected to increase with climate change. The short-term health outcomes associated with dust storms in the US are not well characterized, especially for morbidity outcomes. Objective: To estimate associations between dust storms and diagnosis-specific emergency department (ED) visits during 2005 to 2018. Design, Setting, and Participants: In this cross-sectional study using a time-stratified case-crossover design, short-term associations between dust storms and ED visits were estimated at the zip code level using conditional Poisson analysis with adjustment for meteorology and within-month trends. Same-day dust storm events and storm events within a lag period of up to 7 days were considered. State-wide patient-level ED visit records acquired from 3 state health departments (Arizona, California, and Utah) were analyzed. Data were analyzed between April 21 and November 12, 2024. Exposures: Dust storm events were reported by the US National Weather Service and assigned to each patient zip code that had at least a 5% areal overlap with the National Weather Service forecast zone. Main Outcomes and Measures: Patient-level ED visits for asthma, chronic obstructive pulmonary disease, culture-negative pneumonia, congestive heart failure (CHF), cerebrovascular disease, ischemic heart disease, and visits due to motor vehicle accidents. Results: The analysis included 33500 ED visits among the outcomes of interest (5717 children aged 0-17 years [17.1%] and 11150 adults aged >65 years [33.3%]; 17394 male [51.9%] and 16104 female [48.1%]; 2829 Black [8.4%] and 22537 White [67.2%]; 9256 Hispanic [27.6%]) and 206 dust-impacted zip codes. The strongest associations between dust storms and ED visits were found for asthma (lag 0-2 relative risk [RR], 1.06; 95% CI, 1.01-1.11; P =.03), culture-negative pneumonia (lag 0-7 RR, 1.06; 95% CI, 1.02-1.10; P =.002), CHF (lag 0-7 RR, 1.06; 95% CI, 1.01-1.10; P =.01), and motor vehicle accidents (lag 0 RR, 1.13; 95% CI, 1.04-1.23; P =.003). Associations of dust storm exposure with ischemic heart disease were mostly protective (eg, lag 0-2 RR, 0.89; 95% CI, 0.84-0.95; P