Impact of proximity of thermoelectric power plants on bronchial obstructive crisis rates.

BACKGROUND: Environmental pollution is a risk factor for cardiorespiratory diseases. Energy generated by thermoelectric power plants (TEPP) represents a relevant source of pollution. The aim of this study was to evaluate the relationship between living near a coal-fired TEPP and the consultation rates for bronchial obstructive crises (BOC) in the province of Concepción, Chile. METHODS: Population-based study. The epidemiological weeks from 2012 to 2014 were analyzed. The dependent variable was the emergency consultation rate for BOC in two health centers within 5 km of a TEPP (Coronel) and two that were more than 40 Km away from a TEPP (Talcahuano). The independent variables were the commune, climatological variables (air temperature and relative atmospheric humidity), environmental pollutants (PM10, PM2.5 and nitrogen oxide), weeks with the highest consultation rate and the years. Rates, Pearson's correlation and gross risk measures were calculated and adjusted for environmental and climatological variables. RESULTS: BOC rates were significantly higher in Coronel (RR = 4.9 95% CI 4.0-5.8; p < 0.05). The PM2.5 it showed the strongest correlation with BOC rates (r = 0.3; p < 0.01) in Coronel, but not Talcahuano. Linear regression modelling indicated that proximity to a TEPP (health center location) and temperature explained 26 and 18% of the variance in BOC rates, respectively. CONCLUSIONS: Rates of emergency consultation for BOC were significantly higher among a population living within 5 km of a coal-fired TEPP than those living 40 km away.

Tear gas exposure and its association with respiratory emergencies in infants and older adults during the social uprising of 2019 in Chile: an observational, longitudinal, repeated measures study.

OBJECTIVE: To evaluate if extensive use of tear gas during the Chilean social uprising of 2019 was associated with a higher frequency of respiratory emergencies and bronchial diseases in a residential vulnerable population. DESIGN: Observational, longitudinal, repeated measures study. SETTINGS: Six healthcare centres (one emergency department and five urgent care centres) in the city of Concepción, Chile during 2018 and 2019. PARTICIPANTS: This study was conducted on daily respiratory emergencies and diagnosis. Daily frequency of urgency and emergency visits are administrative data, publicly available and previously de-identified. PRIMARY AND SECONDARY OUTCOME MEASURES: Absolute and relative frequency of daily respiratory emergencies in infants and older adults. A secondary outcome was the relative frequency of bronchial diseases (International Classification of Diseases 10th Revision, ICD-10: J20-J21; J40-J46) in both age groups. We finally measured the rate ratio (RR) of bronchial diseases above the daily grand mean, since the number of visits with these diagnoses in several days was zero. Tear gas exposure was assessed as the uprising period. Models were adjusted by weather and air pollution information. RESULTS: Percentage of respiratory emergencies during the uprising rose by 1.34 percentage points (95% CI 1.26 to 1.43) in infants and 1.44 percentage points (95% CI 1.34 to 1.55) in older adults. In infants, the emergency department experienced a larger increment in respiratory emergencies (6.89 percentage points; 95% CI 1.58 to 2.28) than the urgent care centres (1.67 percentage points; 95% CI 1.46 to 1.90). The RR of bronchial diseases above the daily grand mean during the uprising period was 1.34 in infants (95% CI 1.15 to 1.56) and 1.50 in older adults (95% CI 1.28 to 1.75). CONCLUSIONS: The massive use of tear gas increases the frequency and probability of respiratory emergencies and particularly bronchial diseases in the vulnerable population; we recommend revising public policy to restrict its use.