Respiratory and nervous system effects of a hydrogen sulfide crisis in Carson, California.

BACKGROUND

In October 2021, many residents in Carson, California experienced malodors, headaches, and respiratory symptoms. Hydrogen sulfide (HS), a toxic odorous gas, was measured in Carson at concentrations up to 7000 parts per billion (ppb) and remained above California's acute air quality standard of 30 ppb for about a month. Research on how low- and medium-level HS exposure affects the respiratory and nervous systems has yielded conflicting results, and few studies have examined the effects of subacute HS exposure.

METHODS

We calculated daily rates of emergency department (ED) visits with various respiratory and nervous systems diagnosis codes in Carson area ZIP codes (≤6 km from event's epicenter) and in Los Angeles County ZIP codes >15 km from event's epicenter (control area). Using controlled interrupted time series, we compared ED visit rates during the month of the HS crisis in Carson to the predicted rates had the incident not occurred, based on 2018-2021 ED trends, and controlling for ED visit rate changes in the control area.

RESULTS

We observed a 24 % increase in ED visit rate for all respiratory system diseases (rate ratio = 1.24, 95 % CI: 1.16, 1.32), a 38 % increase for asthma (RR = 1.38, 95 % CI: 1.26, 1.50), a 26 % increase for acute upper respiratory infections (RR = 1.26, 95 % CI: 1.13, 1.38), a 21 % increase for dizziness (RR = 1.21, 95 % CI: 1.04, 1.38), and a 25 % increase for migraines and headaches (RR = 1.25, 95 % CI: 1.13, 1.36) in the Carson area during the first month of the HS event compared to the expected rates.

CONCLUSIONS

This HS crisis was associated with increased ED visit rates for multiple respiratory and nervous system outcomes. Reducing HS exposure and improving to response during HS episodes may improve public health.