Estimating the Impact of Air Pollution on Healthcare-Seeking Behaviour by Applying a Difference-in-Differences Method to Syndromic Surveillance Data

Syndromic surveillance data were used to estimate the direct impact of air pollution on healthcare-seeking behaviour, between 1 April 2012 and 31 December 2017. A difference-in-differences approach was used to control for spatial and temporal variations that were not due to air pollution and a meta-analysis was conducted to combine estimates from different pollution periods. Significant increases were found in general practitioner (GP) out-of-hours consultations, including a 98% increase (2-386, 95% confidence interval) in acute bronchitis and a 16% (3-30) increase in National Health Service (NHS) 111 calls for eye problems. However, the numbers involved are small; for instance, roughly one extra acute bronchitis consultation in a local authority on a day when air quality is poor. These results provide additional information for healthcare planners on the impacts of localised poor air quality. However, further work is required to identify the separate impact of different pollutants.