Role of medicines dispensation data in city-based air-health surveillance and health preparedness

Introduction

Air pollution in India is a significant public health issue. Air-health surveillance has been recently introduced in heavily polluted Indian cities, to inform relevant mitigation and health preparedness actions. The air-health surveillance tracks emergency room visits (ERV) for acute respiratory illnesses in select sentinel hospitals. Reporting from multiple facilities is necessary to get a representative picture, but expanding coverage poses challenges. In this context, pharmaceutical data can serve as an alternative data source to aid surveillance efforts.

Methods

We examined the potential role of data on sales of respules (a combination of corticosteroid and bronchodilator medicines, used in nebulizers) as an indicator in air-health surveillance. The association between daily respules sold at a trust-based hospital in Pune, India, and daily concentration of local ambient particulate matter (PM_2.5) was assessed using a time-stratified case-crossover design.

Results

A positive correlation, with a lag effect, was observed. A 10 µg/m³ increase in PM_2.5 level led to an 8 % and 6 % increase in respules sales after a lag of 3 and 4 days, respectively. The number of respules sold correlated well with ERV.

Discussion

The findings indicate that respules sold could serve as a reliable proxy for tracking health impacts from air pollution.

Conclusion

Our study provides a proof-of-concept analysis showing that pharmaceutical data can be used as a proxy measure to assess the short-term health impacts of air pollution. Further exploration is needed to evaluate its utility for air-health surveillance efforts in India.