Impacto de la contaminación ambiental en las consultas pediátricas de Atención Primaria: estudio ecológico

Abstract

Objective: To study the correlation between the levels of environmental pollutants and the number of paediatric consultations related to respiratory disease in Primary Health Care. Patients and methods: An ecological study is performed, in which the dependent variable analysed was the number of paediatric consultations in an urban Primary Health Care centre in Madrid over a 3 year period (2013-2015), and specifically the consultations related to bronchiolitis, recurrent bronchospasm, and upper respiratory diseases. The independent variables analysed were the levels of environmental pollutants. Coefficients of correlation and multiple lineal regressions were calculated. An analysis has been carried out comparing the average of paediatric consultations when the levels of nitrogen dioxide (NO 2 ) were higher and lower than 40 μg/m 3. Results: During the period of the study, there were a total of 52,322 paediatric consultations in the health centre, of which 6,473 (12.37%) were related to respiratory diseases. A positive correlation was found between SO 2 , CO, NOx and NO 2 and benzene levels and paediatric consultations related to respiratory diseases, and a negative correlation with temperature. The number of consultations was significantly higher when NO 2 levels exceeded 40 μg/m 3 . In the multiple lineal regression (P=.0001), the correlation was only positive between consultations and NO 2 levels (3.630, 95% CI: 0.691-6.570), and negative with temperature (−5,957, 95% CI: −8.665 to −3.248). Conclusions: NO 2 environmental pollution is related to an increase in respiratory diseases in children. Paediatricians should contribute to promote an improvement in urban air quality as a significant preventive measure.