Changes in emergency department visits for respiratory and cardiovascular disease after closure of a coking operation near Pittsburgh, PA

Abstract

Introduction: In Allegheny County (AC), PA, US, closure of a large coke plant in January 2016 presented an opportunity to investigate the contribution of air pollutants to health outcomes in a nearby community. Materials and methods: The Allegheny County Health Department, (ACHD), Division of Air Quality, had begun monitoring pollutants near the plant since June 2011. The rates of hospitalizations and ED visits for cardiovascular and respiratory disease were compared in the exposed community and two control areas: exposed control, with another coking operation; and unexposed control. Results: Of the study and two control areas, particulate matter concentrations decreased the most in the study area, from 10.9 µg/m3 to 9.7 µg/m3. Benzene decreased substantially in that area, from 0.27 ppm to 0.10 ppm. ED visits for cardiovascular, respiratory, and asthma were significantly higher in the exposed group in 2015 compared to 2016. There were no temporal differences in either control groups. There was a 26.5% decrease in cardiovascular ED visits, a 37.9% decrease in respiratory ED visits, and a 3-5 fold decrease in ED visits due to asthma. These decreases were not seen in exposed and unexposed control areas. A case-crossover analysis confirmed that daily ED visits were significantly associated with daily particulate matter levels, controlling for temperature. Conclusion: With the closure of a large Coke Plant facility, we found that a modest decrease in particulate matter and a notable decrease in benzene concentration were associated with a significant decrease in emergency room visits not previously documented in other studies.

Keywords

• Natural experiment;
• Epidemiology;
• Particulate matter