Effects of Weather, Air Quality and Geographical Location on Asthma and COPD Exacerbations in the Localities of Worcester and Dudley.

This thesis examines the influence of selected environmental stimuli on spatial and temporal variation in acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD). Evidence indicates that the high level of humidity in the British climate, and the weather associated with the occurrence of mist and fog, may play an important part in the high incidence rates of asthma and COPD in the UK. Recent studies on this subject area are scarce. The influence of geographical features on pollutant concentrations and variation in meteorological conditions is often acknowledged when examining the effect of air quality and weather on respiratory health, but a thorough investigation is rarely conducted. Focussing on the localities of Worcester and Dudley, this research addresses these deficits by incorporating two main study elements. The first stage examined the variation in daily hospital admissions for asthma and COPD between 1998 and 2003. During the second phase of the study programme, a 12-month daily symptom study was undertaken in a cohort of 52 COPD subjects.
The findings from the project demonstrate that relative humidity, temperature and dew point play a significant role in exacerbations of asthma and COPD. The direction of the correlation found for these meteorological variables indicates that their role is of a combined nature, rather than independent of each other, leading to significant changes in respiratory symptoms during weather associated with high levels of airborne water droplets or the formation of mist and fog. The deleterious influence of air pollution on respiratory wellbeing was also confirmed. Particulate matter showed the strongest effect on symptoms in COPD. Particles can serve as nuclei for the formation of airborne water droplets. Enhanced lung retention of droplet borne pollutants, in contrast to dry particles, is possible. Finally, the results from the research provide evidence of increased respiratory symptoms in lower altitude areas of river valleys. The findings show that airflow, humidity and temperature regimes produced in valley regions, by local topographic features, can lead to interaction between meteorological conditions and air pollution that have an adverse effect on respiratory health.