Associations Between Dust Storms and Intensive Care Unit Admissions in the United States, 2000-2015
Anthropogenic climate change is influencing the incidence of dust storms and associated human exposure to
coarse particulate matter (PM2.5-10) in the United States (US). Studies have found adverse health consequences
related to dust exposure. These consequences include respiratory disease exacerbations and premature mortality,
resulting in increased health care utilization. However, the impact of dust storms on critical care demand has not
been studied in the US. We seek to quantify the relationship between dust storms and surges in critical care
demand by investigating the association between dust storms and intensive care unit (ICU) admissions at nearby
hospitals from 2000 to 2015. ICU data were acquired from Premier, Inc. and encompass 15-20% of all ICU
admissions in the US. Dust storm, meteorology, and air pollutant data were downloaded from the US National
Weather Service, the US National Climatic Data Center, and the US Environmental Protection Agency websites,
respectively. Associations between ICU admission and dust storms, controlling for temperature, dew point
temperature, ambient PM2.5 and ozone, as well as seasonally varying confounders, were estimated using a
distributed lag conditional Poisson model with over-dispersion. We found a 4.8% (95% CI: 0.4, 9.4; p=0.033)
increase in total ICU admissions on the day of the dust storm (lag 0) and a 9.2% (95% CI: 1.8, 17.0; p=0.013)
and 7.5% (95% CI: 0.3, 15.2; p=0.040) increase in respiratory admissions at lags 0 and 5. North American dust
storms are associated with increases in same day and lagged demand for critical care services at nearby
hospitals.
Plain Language Summary
Human influences to climate change are affecting dust storm occurrences and human exposure to dust particles
in the United States (US). Studies worldwide have found negative health consequences related to dust exposure
resulting in increased emergency department visits and hospitalizations. This study seeks to better understand
the relationship between dust storms and critical care demand in hospitals by investigating the association
between dust storms and intensive care unit (ICU) admissions. ICU data were acquired and encompass 15-20%
of US ICU admissions. Associations between ICU admissions and dust storms, controlling for multiple
variables, were estimated. We found an increase in total ICU and respiratory admissions on the day of the dust
storm as well as respiratory admissions five days later. This study is the first national-scale study of dust storms
and critical care demand in the US. Our results contribute to a growing body of evidence showing that dust
exposure affects health and health care utilization, especially for life-threatening respiratory admissions. These
results suggest that public health prevention and healthcare system readiness are necessary to buffer potential
negative impacts to patients, especially those most sensitive to dust exposure, and health care systems resulting from surges in demand for critical care services