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Combined exposure to birch pollen and thunderstorms affects respiratory health in Stockholm, Sweden
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  • Mare Lõhmus,
  • Tomas Lind,
  • Laura MacLachlan,
  • Agneta Ekebom,
  • Björn Gedda,
  • Pia Östensson,
  • Antonios Georgelis
Mare Lõhmus
Karolinska Institutet Institutet for miljomedicin

Corresponding Author:mare.lohmus.sundstrom@ki.se

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Tomas Lind
Karolinska Institutet Institutet for miljomedicin
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Laura MacLachlan
Karolinska Institutet Institutet for miljomedicin
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Agneta Ekebom
Department of Environmental Research and Monitoring Swedish Museum of Natural History PO Box 50007 104 05 Stockholm Sweden
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Björn Gedda
Department of Environmental Research and Monitoring Swedish Museum of Natural History PO Box 50007 104 05 Stockholm Sweden
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Pia Östensson
Department of Environmental Research and Monitoring Swedish Museum of Natural History PO Box 50007 104 05 Stockholm Sweden
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Antonios Georgelis
Karolinska Institutet Institutet for miljomedicin
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Abstract

Background: Thunderstorm asthma is a term used to describe surges in acute respiratory illnesses following a thunderstorm and is often attributed to an intense exposure to aeroallergens. Several episodes of epidemic thunderstorm asthma have been observed worldwide; however, no such cases have been described in Sweden. In Sweden, the most prominent exposure to air-borne pollen occurs during the blooming of the birch. We aimed to explore the potential associations between the respiratory health and the combined exposure to thunderstorms and birch pollen. Methods: We investigated the association between the daily numbers of outpatient visits due to respiratory cases and the combined exposure to thunderstorms and birch pollen during a period of May 1 st - August 31 st in 2001-2017, in Stockholm County, Sweden, by using time series analysis with log linear models. Results: We detected a significant increase in the number of outpatient visits on both the same day and the day after the occurrence of a thunderstorm, when either the concentrations of ambient birch pollen or the number of thunderstorm-associated lighting discharges were within the highest categories. Conclusions: It is possible that co-exposure to heavy thunderstorms and high concentrations of birch pollen affects the respiratory health of the Stockholm population. To the best of our knowledge, this is the first study addressing the thunderstorm-related respiratory illnesses in Sweden and the effect of birch pollen. Other similar studies are needed before any conclusions can be drawn; however, our study may be important for future public health advice related to thunderstorm asthma.