Seasonal variations in respiratory morbidity in primary care and its correlation with the quality of air in urban Odisha, India.

Poor air quality, especially in urban regions among low-and middle-income countries such as India poses a significant healthcare challenge. Amongst urban areas, metropolitan cities garner the utmost importance for air quality related policies and studies with limited studies from tier II cities which are thought to be relatively immune to air pollution. Hence, we aimed to identify the most frequent respiratory morbidities and explore its correlation with exposure to ambient PM2.5 particles in Bhubaneswar (a tier II city in coastal India), Odisha. A chart review was carried out through data extracted from the records of urban health centres. Data on PM2.5 concentrations were obtained from Odisha State Pollution Control Board. The morbidities were coded by using the International Classification of Primary Care‑2 system (ICPC-2). Descriptive statistics such as incidence of respiratory illnesses was computed across seasons. The ecological correlation between respiratory morbidity patterns and corresponding concentration of PM2.5 in air was analysed for each season. A positive correlation (r = o.94) between PM2.5 and respiratory morbidities was observed. The incidence of respiratory morbidities was 183.31 per 1000 person year. We identified 21 out of 43 respiratory diseases classified under ICPC-2. Upper Respiratory Tract Infection was the most commonly (116.8 per 1000 person year) incident condition. We observed one-fourth increase in the incidence of respiratory illnesses during winters. Respiratory morbidities are common in urban Bhubaneswar which follows a seasonal pattern and are possibly linked with the seasonal variations in levels of PM2.5 particles. Our study highlights that tier II cities are equally prone to health effects of air pollution. Future programmes and policies should take these cities into consideration too.