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Shop Floor Epidemiology

Bandolier gets asked for all sorts of help. Sometimes we can help. Often we can't. Dr Down from Surrey has a particular problem in his practice, whose population lies in a pocket surrounded by the M25 and A3. Most of the population lives within a couple of miles of these roads. He has seen a rising incidence of respiratory complaints (asthma, otitis media, Eustachian tube dysfunction and allergic rhinitis). With a proposed new service station planned, can anyone help with evidence linking symptoms with roads and service stations?

Dr Down's letter

Dear Dr Moore,

I am writing to ask whether Bandolier has access to any data relating to the prevalence of respiratory tract disease in and around motorways and motorway service areas. In particular whether such data analysis exists linking air pollution - especially PM10s to the prevalence of respiratory tract disease. The Department of Transport has I believe admitted that PM10 pollution is an area that needs to be further investigated whilst not yet being able to establish clear links between other indices of air pollution and the prevalence of asthma.

The graph illustrates the monthly consulting frequency of common respiratory tract disease over the last five years. Whilst our practice population has not varied by more than 2%, the monthly consulting incidence for asthma, Eustachian tube dysfunction, serous otitis and allergic rhinitis has more than doubled during that time. (Data is recorded in consultation using Read codes for the presenting complaint. Our practice population is drawn from villages situated to the north and north-east of the M25.)

I would be most interested to hear from you on the matter, especially now that a Motorway service area to the south of the practice is the subject of a public enquiry.

Yours sincerely,

Dr N A C Down
Oxshott Medical Practice
Holtwood Rd
Surrey KT22 0QL Fax 01372 842558

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