Dataset Information

Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China.

ABSTRACT: Air pollutants are associated with cardiovascular death; however, there is limited evidence of the effects of different pollutants on out-of-hospital cardiac arrests (OHCAs) in Beijing, China. We aimed to investigate the associations of OHCAs with the air pollutants PM_2.5-10 (coarse particulate matter), PM_2.5 (particles ?2.5 ?m in aerodynamic diameter), nitrogen dioxide (NO?), sulfur dioxide (SO?), carbon monoxide (CO), and ozone (O?) between 2013 and 2015 using a time-stratified case-crossover study design. We obtained health data from the nationwide emergency medical service database; 4720 OHCA cases of cardiac origin were identified. After adjusting for relative humidity and temperature, the highest odds ratios of OHCA for a 10 ?g/m³ increase in PM_2.5 were observed at Lag Day 1 (1.07; 95% confidence interval (CI): 1.04-1.10), with strong associations with advanced age (aged ?70 years) (1.09; 95% CI: 1.05-1.13) and stroke history (1.11; 95% CI: 1.06-1.16). PM_2.5-10 and NO? also showed significant associations with OHCAs, whereas SO?, CO, and O? had no effects. After simultaneously adjusting for NO? and SO? in a multi-pollutant model, PM_2.5 remained significant. The effects of PM_2.5 in the single-pollutant models for cases with hypertension, respiratory disorders, diabetes mellitus, and heart disease were higher than those for cases without these complications; however, the differences were not statistically significant. The results support that elevated PM_2.5 exposure contributes to triggering OHCA, especially in those who are advanced in age and have a history of stroke.

SUBMITTER: Xia R

PROVIDER: S-EPMC5409624 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Publications

Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China.

Xia Ruixue R Zhou Guopeng G Zhu Tong T Li Xueying X Wang Guangfa G

International journal of environmental research and public health 20170414 4

Air pollutants are associated with cardiovascular death; however, there is limited evidence of the effects of different pollutants on out-of-hospital cardiac arrests (OHCAs) in Beijing, China. We aimed to investigate the associations of OHCAs with the air pollutants PM<sub>2.5-10</sub> (coarse particulate matter), PM<sub>2.5</sub> (particles ≤2.5 μm in aerodynamic diameter), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and ozone (O₃) between 2013 and 2015 using a time-stra ...[more]

PMID: 28420118

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Project description:BackgroundAir pollution disparities by socioeconomic status (SES) are well documented for the United States, with most literature indicating an inverse relationship (i.e., higher concentrations for lower-SES populations). Few studies exist for China, a country accounting for 26% of global premature deaths from ambient air pollution.ObjectiveOur objective was to test the relationship between ambient air pollution exposures and SES in China.MethodsWe combined estimated year 2015 annual-average ambient levels of nitrogen dioxide (NO2) and fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] with national demographic information. Pollution estimates were derived from a national empirical model for China at 1-km spatial resolution; demographic estimates were derived from national gridded gross national product (GDP) per capita at 1-km resolution, and (separately) a national representative sample of 21,095 individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2015 cohort. Our use of global data on population density and cohort data on where people live helped avoid the spatial imprecision found in publicly available census data for China. We quantified air pollution disparities among individual's rural-to-urban migration status; SES factors (education, occupation, and income); and minority status. We compared results using three approaches to SES measurement: individual SES score, community-averaged SES score, and gridded GDP per capita.ResultsAmbient NO2 and PM2.5 levels were higher for higher-SES populations than for lower-SES population, higher for long-standing urban residents than for rural-to-urban migrant populations, and higher for the majority ethnic group (Han) than for the average across nine minority groups. For the three SES measurements (individual SES score, community-averaged SES score, gridded GDP per capita), a 1-interquartile range higher SES corresponded to higher concentrations of 6-9 μg/m3 NO2 and 3-6 μg/m3 PM2.5; average concentrations for the highest and lowest 20th percentile of SES differed by 41-89% for NO2 and 12-25% for PM2.5. This pattern held in rural and urban locations, across geographic regions, across a wide range of spatial resolution, and for modeled vs. measured pollution concentrations.ConclusionsMultiple analyses here reveal that in China, ambient NO2 and PM2.5 concentrations are higher for high-SES than for low-SES individuals; these results are robust to multiple sensitivity analyses. Our findings are consistent with the idea that in China's current industrialization and urbanization stage, economic development is correlated with both SES and air pollution. To our knowledge, our study provides the most comprehensive picture to date of ambient air pollution disparities in China; the results differ dramatically from results and from theories to explain conditions in the United States. https://doi.org/10.1289/EHP9872.

Dataset Information

Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China.

Publications

Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China.

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