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AN ASSESMENT OF THE POTENTIAL FOR CO-EXPOSURE TO ALLERGENIC POLLEN AND AIR POLLUTION IN COPENHAGEN, DENMARK

Pia Viuf Ørby1, Robert Peel2, Carsten Ambelas Skjøth3, Vivi Schlünssen1, Jakob Bønløkke1, Thomas Ellermann2, Andreas Brændholt5, Torben Sigsgaard1, Ole Hertel2,4

1Unit of Environmental and Occupational Medicine (DEOM), Department of Public Health, Aarhus University, 2Department for Environmental Science, Aarhus University, 3National Pollen and Aerobiology Research Unit, University of Worcester, 4Department for Environmental, Social and Spatial Change (ENSPAC), Roskilde University. 5Asthma-Allergy Association

Denmark.

Background. Co-exposure to air pollutants and allergenic pollen can exacerbate allergic airway diseases.

Charts above.Yearly plots of 11-day running mean for 1997-2012 for PM (a) and the gasses O3, NO2 and SO2 (b) for both roadside (Jagtvej or HCAB) and urban background (HCØ). Typical birch and grass pollen seasons based on the period 1985-2009 are shaded grey.

Charts, left.Diurnal charts of the average patterns of (a) birch pollen and (b) grass pollen on peak and non-peak pollen days. Peak pollen days are days with concentrations above 50 grains m-3 for grass pollen and 100 grains-3 for birch.

Charts above.Diurnal charts of the average patterns of pollutants with standard error of the means; (a) PM2.5 at roadside (HCAB) and rooftop (HCØ) , (b) PM10 at roadside (HCAB) and rooftop (HCØ), (c) O3 and NO2 at HCØ rooftop station, (d) NO2 at roadside (Jagtvej) roadside station, (e) O3 at Jagtvej roadside station, (f) SO2 at HCAB roadside station.

HCØ Jagtvej HCAB Pollen monitoring station NO2 O3 PM10 PM2.5 NO2 O3 PM10 SO2 PM2.5 Grass Birch

Gra

ss s

easo

n P

eak

days

Mean (range) 9.4 (3.0-23.2)

36.5 (23.8-8.6)

25.3 (9.6-51.6)

26.6 (2.5-86.4)

23.4 (4.5-56.9)

26.5 (11.0-49.5)

31.9 (7.8-64.8)

1.01 (-0.05-7.43)

20.4 (6.7-48.7)

92.1 (50-285)

n, sample size * 147 102 107 31 173 159 132 135 63 175

rs (p), bi-hourly -1.2*10-4 (0.996)

0.246 (< 0.001)

0.244 (< 0.001)

0.078 (0.035)

0.096 (< 0.001)

0.168 (< 0.001)

- 0.066 (0.008)

0.115 (< 0.001)

rs (p), daily 0.083 (0.320)

0.071 (0.478)

0.208 (0.032)

0.071 (0.705)

0.036 (0.635)

0.109 (0.173)

0.268 (0.002)

0.025 (0.770)

0.075 (0.562)

Non

pea

k da

ys Mean (range)

9.2 (1.9-26.6)

32.3 (13.2-49.5)

22.4 (2.1-56.9)

25.8 (0-124.9)

21.8 (3.8-53.3)

21.6 (6.7-40.2)

28.7 (0-71.6)

1.08 (-0.18-5.24)

16.4 (2.5-36.1)

14.1 (1-49)

n, sample size * 621 352 402 158 665 583 486 431 233 692

rs (p), bi-hourly -0.116 (< 0.001)

0.242 (< 0.001)

0.043 (0.014)

0.070 (< 0.001)

-0.063 (< 0.001)

0.204 (< 0.001)

- -0.017 (0.230)

-0.015 (0.341)

rs (p), daily -0.019 (0.634)

0.182 (< 0.001)

-0.014 (0.782)

0.126 (0.114)

-0.037 (0.337)

0.175 (< 0.001)

0.024 (0.596)

-0.084 (0.083)

0.063 (0.340)

Wilcoxon test p = 0.442 z = 0.768

p < 0.001 z = 5.130

p < 0.001 z = 3.385

p = 0.315 z = 1.004

p = 0.186 z = 1.322

p < 0.001 z = 7.601

p = 0.012 z = 2.512

p = 0.704 z = -0.380

p < 0.001 z = 3.563

p < 0.001 z = 20.515

Bir

ch s

easo

n

Pea

k da

ys

Mean (range) 12.3 (2.6-25.7)

39.7 (23.1-62.9)

31.0 (10.9-63.4)

29.2 (1.3-121.1)

29.4 (4.9-54.7)

24.7 (5.5-49.3)

42.9 (13.5-77.4)

1.44 (-0.04-5.52)

24.2 (4.2-50.6)

544.0 (103-3974)

n, sample size * 137 89 96 33 142 119 102 107 55 143

rs (p), bi-hourly -0.053 (0.032)

0.340 (< 0.001)

-0.026 (0.459)

0.120 (0.005)

0.084 (< 0.001)

0.173 (< 0.001)

- 0.138 (< 0.001)

0.071 (0.061)

rs (p), daily -0.215 (0.012)

0.324 (0.002)

0.002 (0.988)

-8.4*10-4 (0.996)

-0.093 (0.273)

0.267 (0.003)

-0.163 (0.102)

0.020 (0.837)

0.014 (0.918)

Non

pea

k da

ys Mean (range)

11.1 (2.9-27.7)

36.9 (23.5-50.4)

22.2 (6.0-64.8)

20.1 (2.7-67.2)

26.8 (6.0-45.0)

21.9 (6.5-40.5)

36.2 (9.7-93.4)

1.22 (-0.05-4.28)

19.1 (8.3-38.9)

38.6 (1-98)

n, sample size * 154 74 80 34 148 129 91 81 47 155

rs (p), bi-hourly -0.048 (0.041)

0.098 (0.004)

0.031 (0.395)

0.082 (0.119)

0.037 (0.116)

0.160 (< 0.001)

- 0.066 (0.039)

-0.039 (0.289)

rs (p), daily -0.147 (0.069)

-0.052 (0.661)

0.027 (0.811)

-0.102 (0.565)

-0.071 (0.395)

0.249 (0.004)

-0.126 (0.234)

0.037 (0.741)

0.073 (0.626)

Wilcoxon test p = 0.072 z = 1.800

p = 0.063 z = -1.855

p < 0.001 z = -5.323

p = 0.063 z = 1.863

p = 0.019 z = 2.330

p = 0.020 z = 2.321

p < 0.001 z = -3.462

p = 0.109 z = -1.605

p = 0.006 z =-2.726

p < 0.001 z = 14.912

Time period 1997-2012 07/2003-2012

05/2002-2012

03/2008-2012

1997-2012 1997-01/2011

07/2000-2012

03/2001-2012 04/2007-2012

1997-2012 1997-2012

* Number of days with less than 0.5mm rain and maximum 3-hour gaps within a day.

Contact: Pia Viuf Ørby, piv@ph.au.dk

Birch pollen 25 um

Grass pollen 35 um

Aim. Patterns in pollutant and pollen concentrations at which co-exposure may be a particular risk with respect to adjuvant health effects were analysed by:- Comparing the yearly pattern of the concentrations of pollutants with the timing of pollen seasons.- Comparing the average diurnal pattern of

concentrations of pollen and pollutants on days with (a) high pollen concentrations and for (b) the remaining part of the pollen season.

This is pursued in order to establish if there are typical patterns of concurrently high concentrations, which could affect the guidance to the allergic and asthmatic public.

Methods. We examined yearly variation and diurnal patterns of pollutants on days with high pollen levels, and also for the remaining part of the pollen season, for the following:grass and birch pollen, sulphur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) in the period 1997-2012.

Results.O3 concentrations were increased on days with peak pollen concentrations. High O3 concentrations coincide both seasonally and diurnally with high pollen counts, potentially leading to clinically relevant simultaneous co-exposure. NO2 and SO2 peaks did not coincide with peaks in pollen concentrations, and were well below potential thresholds for adjuvant effects to the allergic reaction. Neither diurnal nor seasonal peaks in PM coincide with pollen peaks, however daily average PM concentrations were higher on peak pollen days than on non-peak days. 

Conclusions. This study indicates that when considering co-exposure effects from pollen and pollutants, O3 appears to be the most relevant pollutant to further examine for clinical effects of simultaneous co-exposures.

Results shown are under review for publication in the journal Urban Climate.

Co-exposure to ozone and allergenAfter one hour of exposure to 120 ppb of O3, Molfino et al. [1991] found that only half the allergen dose was needed to provoke a 20% drop in FEV1 compared to exposure to clean air. The O3 concentrations observed in this study are lower than these, but their effect are expected to be of clinical relevance [Van Bree et al., 1995].

References. Molfino, N. A., Wright, S. C., Katz, I., Tarlo, S., Silverman, F., McClean, P. A., Slutsky, A. S., Zamel, N., Szalai, J. P., and Raizenne, M., Effect of low concentrations of ozone on inhaled allergen responses in asthmatic subjects, The Lancet 338 (1991) 199-203, Van Bree, L., Marra, M., Van Scheindelen, H. J., Fischer, P. H., De Loos, S., Buringh, E., and Rombout, P. J. A., Dose-effect models for ozone, Toxicol. Lett. Volumes 82-83 (1995) 317-321