Pollution affects both health and climate change. There is no published research on the use of four environmental pollution exposure codes new to ICD-10-CM. The purpose of this research is to provide a baseline use of the four codes in Florida, the most frequent related principal diagnoses, demographics of patients exposed to environmental pollution, total charges, and associations of total charges that are related to environmental pollution.

There were 341 patients in Florida who visited an ED due to environmental pollution exposure from 2016 to 2019 and 159 patients in Florida who were hospitalized. The total charges for all patients with a documented exposure to environmental pollution were $1,379,217 for ED patients and $9,933,752 for inpatients. The independent variables that were statistically significant in the ED regression model of total charges were other insurance (-0.361 parameter estimate, 0.017 p-value, -30.3% decrease to charges); and for-profit ownership (0.376 parameter estimate, 0.0005 p-value, 45.7% increase to charges). For the inpatient regression model, the independent variables that were statistically significant were Medicare (0.317 parameter estimate, 0.027 p-value, 37.3% increase to charges); LOS (0.091 parameter estimate, <0.0001 p-value, 9.5% increase to charges); exposure to other pollution (0.407 parameter estimate, 0.002 p-value, 50.3% increase to charges); and for-profit hospital ownership (0.292 parameter estimate, 0.012 p-value, 33.9% increase to charges).

Patients exposed to air pollution frequently were diagnosed with asthma or other chronic obstructive pulmonary disease. Patients with water pollution exposure frequently had open wounds or infections stemming from open wounds. For both ED and inpatient visits, $11,312,969 was charged to patients over the four year period. Due to the challenges of documenting it clinically, the true charges of healthcare due to environmental pollution are probably much higher. Education may be needed for pollution codes to be understood and used more frequently by clinicians and coders.