ASSOCIATION BETWEEN EXPOSURES OF PARTICULATE MATTER 2.5 AND POLLEN ANTIGENS WITH ACUTE PRECIPITATION OF RESPIRATORY SYMPTOMS: A PROSPECTIVE STUDY IN ADULTS OF A CITY IN INDIA AND AHPCO AS A REMEDY

In India, air pollution has been the fifth leading cause of death. Studies have conferred serious health outcomes in people living in polluted areas with fine particulate matter (PM 2.5) values exceeding permissible limits. Particulate matter with such lesser aerodynamic diameter poses greater respiratory risk factor due to its propensity to reach deep down the lungs and come in contact with the blood. Both short and long term exposures are linked to serious respiratory outcomes. At this outset, a prospective study was conducted on the adult residents of a known polluted area, who developed acute respiratory symptoms on exposure to PM 2.5 and grass pollen grains over a period of more than a year. The study tried to probe the association between PM 2.5 and grass pollen exposure with daily clinic visits due to precipitation of acute respiratory symptoms and its probable relation with seasonal variation throughout the year. A prospective observational study was conducted in a part of city of Howrah in state of West Bengal of Eastern India. The study area was important for having all the four sources of PM 2.5. The study included all the permanent adult residents (aged >20 yrs. to <70 yrs.) exposed to both ambient air pollutant and grass pollen persistently throughout the year (1-32 pollen/day/mm3). Data of the airborne grass pollen samples were collected using Burkard volumetric sampler and pollen count was obtained. A 24 hours Ambient PM 2.5 level of the study area was gathered from the official website of State Pollution Control Board. Private clinics of 32 experienced medical practitioners were identified in the locality and daily clinic visits of patients with acute precipitation of allergic upper respiratory inflammation like allergic rhinitis or allergic rhino conjunctivitis or allergic pharyngitis were noted. Data collected were statistically analyzed. Daily mean concentrations of PM 2.5 in this area was found to be 251.23 microgram/m3 which was quite above the permissible limit as enumerated by NAAQS. Daily mean concentration of pollen grains was found to be 6.77 per cubic meter. The mean PM 2.5 levels followed a trend as the concentrations reached the lowest averages during the summer season, slightly increasing during the monsoon, and reaching its peak during post monsoon and winters. Similarly average grass pollen concentration was found to be minimum in summer or pre-monsoon time, while being at peak in winters. Maximum grass pollen concentration has been observed in monsoon and winters. Average daily clinic visits due to acute precipitation of respiratory symptoms were found to be maximum in winter followed by post and pre-monsoon respectively. Management of respiratory symptoms included oral antihistamines and local steroids. There was significant and positive association between personal exposure to both PM 2.5 and grass pollen with clinic visit due to precipitating respiratory symptoms. Severe AQI was observed in winter and post monsoon time. (p<0.005). The present study showed mean particulate matter concentration throughout the study period being far above the permissible standard limits. Increased aeroallergen concentration in this study was also found prevalent. A seasonal variation of particulate matter and aeroallergen concentration was found to be significantly associated with precipitating respiratory symptoms amongst the residents of this area which upsurges a serious respiratory health concern. Stringent pollution control measures shall help to combat these deteriorating air quality issues thereby promising a healthier, safer and cleaner environment