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Environmental Health
Research

BioMed Central

Open Access

Emergency room visits for respiratory conditions in children increased after Guagua Pichincha volcanic eruptions in April 2000 in Quito, Ecuador Observational Study: Time Series Analysis
Elena N Naumova*1, Hugo Yepes2, Jeffrey K Griffiths1, Fernando Sempértegui3, Gauri Khurana1, Jyotsna S Jagai1, Edgar Játiva4 and BerthaEstrella3
Address: 1Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston MA 02111, USA, 2Instituto Geofisico, Escuela Politecnica Nacional, Quito, Ecuador, 3Corporación Ecuatoriana de Biotecnología, Quito, Ecuador and 4Baca Ortiz Children's Hospital, Quito, Ecuador Email: Elena N Naumova* - elena.naumova@tufts.edu; Hugo Yepes - hyepes@igepn.edu.ec; Jeffrey KGriffiths - jeffrey.griffiths@tufts.edu; Fernando Sempértegui - fersempert@andinanet.net; Gauri Khurana - gauri.khurana@yale.edu; Jyotsna S Jagai - Jyotsna.Jagai@tufts.edu; Edgar Játiva - ejativa@hotmail.com; Bertha Estrella - bestrel@andinanet.net * Corresponding author

Published: 24 July 2007 Environmental Health 2007, 6:21 doi:10.1186/1476-069X-6-21

Received: 12 February 2007 Accepted: 24 July2007

This article is available from: http://www.ehjournal.net/content/6/1/21 © 2007 Naumova et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

Abstract
Background: This study documented elevated rates of emergency room (ER) visits for acute upper and lower respiratory infections and asthma-related conditions in the children of Quito, Ecuador associated with the eruption of Guagua Pichincha in April of 2000. Methods: We abstracted 5169 (43% females) ER records with primary respiratory conditions treated from January 1 – December27, 2000 and examined the change in pediatric ER visits for respiratory conditions before, during, and after exposure events of April, 2000. We applied a Poisson regression model adapted to time series of cases for three non-overlapping disease categories: acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), and asthma-related conditions in boys and girls for threeage groups: 0–4, 5–9, and 10–15 years. Results: At the main pediatric medical facility, the Baca Ortiz Pediatric Hospital, the rate of emergency room (ER) visits due to respiratory conditions substantially increased in the three weeks after eruption (RR = 2.22, 95%CI = [1.95, 2.52] and RR = 1.72 95%CI = [1.49, 1.97] for lower and upper respiratory tract infections respectively. The largest impact oferuptions on respiratory distress was observed in children younger than 5 years (RR = 2.21, 95%CI = [1.79, 2.73] and RR = 2.16 95%CI = [1.67, 2.76] in boys and girls respectively). The rate of asthma and asthma-related diagnosis doubled during the period of volcano fumarolic activity (RR = 1.97, 95%CI = [1.19, 3.24]). Overall, 28 days of volcanic activity and ash releases resulted in 345 (95%CI =[241, 460]) additional ER visits due to respiratory conditions. Conclusion: The study has demonstrated strong relationship between ash exposure and respiratory effects in children.

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Environmental Health 2007, 6:21

http://www.ehjournal.net/content/6/1/21

Background
The danger of living near active volcanoes has been well documentedsince ancient times, from the ruins of Pompeii to the recent satellite images of volcano eruptions. Volcanic activity is typically associated with toxic emissions; pyroclastic flows (the mixture of rock fragments and superheated gases, which can achieve speeds over 100 km/hr and temperatures over 300°C); the release of ash; volcanic gases containing carbon dioxide, water vapor, sulfur dioxide,...
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