Birinci Basamakta Hava Kirliliği ile Semptom ve Tanı Temelli Başvurular Arasındaki İlişki

Abstract

Giriş: Hava kirliliği kötü sağlık sonuçlarıyla ilişkilidir; ancak mevcut kanıtların çoğu hastane verilerine dayanmaktadır. Birinci basamak kayıtları daha erken ve daha hafif klinik başvuruları yakalayabilir. Bu çalışmanın amacı, hava kirleticilerindeki aylık değişimler ile birinci basamaktaki semptom ve tanı bazlı başvurular arasındaki ilişkiyi, özellikle solunum yolu enfeksiyonları, baş ağrısı ve halsizlik/yorgunluk gibi şikayetlere odaklanarak değerlendirmektir.

Yöntem: Bu retrospektif gözlemsel çalışmada, Nisan 2024 ile Nisan 2025 tarihleri arasında Karatay, Konya, Türkiye'deki resmi bir hava kalitesi izleme istasyonuna en yakın konumda bulunan dört aile sağlığı merkezinden alınan aylık ziyaret sayıları analiz edildi. Üst solunum yolu enfeksiyonları (ÜSYE), alt solunum yolu enfeksiyonları (ASYE), baş ağrısı ve halsizlik/yorgunluk için ICD-10 kodlarına göre tanımlandı. PM_2.5, PM₁₀, O₃, NO₂, SO₂ ve CO’ya ait aylık ortalama konsantrasyonlar kamuya açık izlem verilerinden elde edildi. 

Bulgular: Solunum yolu başvuruları, kirletici düzeylerinin zirve yaptığı Aralık 2024–Ocak 2025 döneminde arttı. Aynı ay analizlerinde en güçlü solunum yolu ilişkileri SO₂ (ÜSYE: p=0.005; ASYE: p<0.001) ve CO (ÜSYE: p=0.027, ASYE: p<0.001) ile saptanırken, partikül madde alt solunum yolu enfeksiyonları ile daha tutarlı ilişki gösterdi (PM_2.5: p=0.018, PM₁₀: p=0.036). Baş ağrısı başvuruları O₃ ile ters yönlü ilişkili bulundu (p=0.039).

Sonuç: Kötü hava kalitesi birinci basamakta solunum yolu enfeksiyonu başvurularındaki artışla ilişkili bulundu; baş ağrısı başvuruları ise ozonla ilişkili özgün bir örüntü gösterdi. Birinci basamak verileri, hava kirliliği artış dönemlerinde yerel sağlık hizmeti planlamasını destekleyebilir.

Keywords

• Çevre sağlığı
• Hava kirliliği
• Solunum yolu enfeksiyonları

Relationship Between Air Pollution and Symptom-Diagnosis Based Visits in Primary Care

Abstract

Introduction: Air pollution is associated with adverse health outcomes, but most evidence comes from hospital data. Primary care records may capture earlier and milder presentations. This study aimed to evaluate the association between monthly changes in air pollutants and primary health care visits, stratified by symptoms and diagnosis, particularly respiratory infections and non-specific complaints such as headache and fatigue.

Materials and Methods: This retrospective observational study analyzed monthly visit counts from four family health centers located closest to an official air-quality monitoring station in Karatay, Konya, Türkiye, between April 2024 and April 2025. Outcomes were defined using ICD-10 codes for upper respiratory tract infections (URTI), lower respiratory tract infections (LRTI), headache, and malaise/fatigue. Monthly mean concentrations of PM_2.5, PM₁₀, O₃, NO₂, SO₂, and CO were obtained from public monitoring data. 

Results: Respiratory visits increased during December 2024–January 2025, when pollutant levels peaked. Same-month analyses showed the strongest respiratory associations with SO₂ (URTI: p=0.005; LRTI: p<0.001) and CO (URTI: p=0.027, LRTI: p<0.001), while particulate matter was more consistently linked to LRTI (PM_2.5: p=0.018, PM₁₀: p=0.036). Headache visits were inversely associated with O₃ (p=0.039).

Conclusion: Poorer air quality—particularly elevated SO₂ and CO—was associated with increased respiratory visits in primary care, while headache presentations showed an ozone-related pattern. Primary care data may support local service planning during pollution peaks.

Keywords

• Air Pollution
• Environmental Health
• Respiratory Tract Infections

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