Air pollution and extreme temperatures are important public health problems but their effects on morbidity are not usually measured jointly. The objective was thus to analyse the effect of short-term exposure to both air pollution and to heat and cold waves on emergency hospital admissions at a provincial level, and estimate the economic cost.
Time series study analysing emergency hospital admissions due to natural causes (ICD-9:1-799 and ICD-10: A00-R99) across the period 2013-2018. The independent variables were daily mean concentrations of NO2, PM2.5, PM10 and ozone, the maximum daily temperature in heat waves, and the minimum daily temperature in cold waves. Generalised linear models with a Poisson regression link were used to calculate the relative risks and attributable risks and estimated the related economic cost.
In relation to air pollution, exposure to NO2 showed the greatest association with the number of provinces (39 %) and the highest number of attributable admissions (27,823;95%CI:14181-42,610) and an annual cost of €393,25 million. For the O3, the association with attributable admissions was 22,858; 95%CI:5986-39,683 and an annual cost of €312,76 million. The exposure to PM showed the lowest association with the attributable admissions, 11,203 (95%CI:4470-17,504) and an annual cost of €152,95 million. In the case of extreme temperatures their impact was very much less (5377; 95CI:2347-8373) than that of air pollution and their annual cost of €76.0 million.
According the results found, a considerable number of emergency hospital admissions are mainly attributable to short-term exposure to air pollution instead of the extreme temperatures. The extreme temperatures prevention plans should be implemented to address the impact on health of air pollution and temperatures jointly.