Effect of a diesel engine ban on asthma-related morbidity in Beirut

Mroueh, S., Tamim, H. and El-Fadel, M. (2004) Effect of a diesel engine ban on asthma-related morbidity in Beirut. Sixth International Congress of Pediatric Pulmonolgy, Lisbon, Portugal.

Abstract

Diesel engine exhaust emissions are a mixture of gases, vapors, liquid aerosols and particulate matter that are known to increase cardiorespiratory morbidity.
On July 1, 2002, a ban was imposed on the use of diesel-operated vehicles on the Lebanese territory as a public health measure.
The aim of this study is to determine the effect of this ban on the air concentration of particulate matter and on asthma-related morbidity in the Beirut area.

Methods: Air sampling was done at multiple large intersections of Beirut before and after the ban using a portable high-volume air sampler equipped with glass fiber filters that capture particles of diameter greater than 0.01 microns. Each sample was collected over a period of 30 minutes. The filter was then weighed for particulate matter determination.
The records of all visits to the Emergency Room (ER) of the American University of Beirut Medical Center, a major tertiary care center in Beirut, Lebanon were reviewed over a two-year period. The first year (July 1, 2001 to June 30, 2002 , period 1) preceded the ban while the second year (July 1, 2002 to June 30, 2003, period 2) followed it immediately. All patients 0-15 years of age presenting with acute asthma were identified.

Results: The average concentration of particulate matter was 181.3 µg/m3 and 97.1 µg/m³ before and after the ban respectively.
The total numbers of ER visits for pediatric patients were 6453 and 6865 in period 1 and period 2 respectively. Of those, 313 were due to asthma in period 1 and 223 in period 2. The number of asthma-related visits was significantly reduced during period 2. When we looked at the monthly distribution of visits, asthma-related visits were significantly reduced during October, November and December of period 2 compared to the same months of period 1, while it was significantly increased during the month of June.

Discussion: This study shows that a ban on diesel engine resulted in a decrease in the air concentration of particulate matter and was associated with a reduction in the number of emergency room visits for acute asthma. This reduction was most marked during the season of viral respiratory infections. We postulate that a reduction in the concentration of air pollutants was protective against viral-induced asthma exacerbations.

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