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Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study

Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study

Title: Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
Author: Carlsen, Hanne Krage   orcid.org/0000-0003-1656-9624
Valdimarsdóttir, Unnur Anna
Briem, Haraldur
Dominici, Francesca
Finnbjörnsdóttir, Ragnhildur Guðrún
Jóhannsson, Þorsteinn
Aspelund, Thor   orcid.org/0000-0002-7998-5433
Gíslason, Þórarinn
Guðnason, Þórólfur
Date: 2021-02-27
Language: English
Scope: 990286
Department: Faculty of Medicine
Series: Environmental Health: A Global Access Science Source; 20(1)
ISSN: 1476-069X
DOI: 10.1186/s12940-021-00698-y
Subject: Eldgosið í Eyjafjallajökli; Öndunarfærasjúkdómar; Holuhraun; Holuhraun; Lýðheilsa; Atmospheric transport; Epidemiology; Public health; Respiratory disease; Volcanic eruption; Humans; Middle Aged; Male; Volcanic Eruptions/adverse effects; Young Adult; Sulfur Dioxide/adverse effects; Adult; Female; Registries; Anti-Asthmatic Agents/therapeutic use; Respiratory Tract Diseases/drug therapy; Morbidity; Air Pollutants/adverse effects; Adolescent; Office Visits/statistics & numerical data; Aged; Iceland/epidemiology; Primary Health Care; Emergency Service, Hospital/statistics & numerical data; Environmental Exposure/adverse effects; Public Health, Environmental and Occupational Health; Health, Toxicology and Mutagenesis
URI: https://hdl.handle.net/20.500.11815/2852

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Carlsen , H K , Valdimarsdóttir , U A , Briem , H , Dominici , F , Finnbjörnsdóttir , R G , Jóhannsson , Þ , Aspelund , T , Gíslason , Þ & Guðnason , Þ 2021 , ' Severe volcanic SO 2 exposure and respiratory morbidity in the Icelandic population – a register study ' , Environmental Health: A Global Access Science Source , vol. 20 , no. 1 , 23 . https://doi.org/10.1186/s12940-021-00698-y


BACKGROUND: The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO 2). The aim of this study was to determine the association between volcanic SO 2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area. METHODS: Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO 2 concentration and high SO 2 levels (24-h mean SO 2  > 125 μg/m3) were analysed using generalized additive models. RESULTS: After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO 2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39-1.58%) per 10 μg/m 3 at lag 0-2, in PCMD for respiratory causes 1.26% (95% CI 0.72-1.80%) per 10 μg/m 3 SO 2 at lag 0-2, and in HED by 1.02% (95% CI 0.02-2.03%) per 10 μg/m 3 SO 2 at lag 0-2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1-19.6%), 17.2% (95% CI 10.0-24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49-1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54-1.71%) and 2.08% (1.13-3.04%). CONCLUSION: High levels of volcanic SO 2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible.


The study was funded by the Icelandic Ministry of Health. Publisher Copyright: © 2021, The Author(s).

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