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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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:BackgroundThe impacts of air pollution on circulatory and respiratory systems have been extensively studied. However, the associations between air pollution exposure and the risk of noncommunicable diseases of other organ systems, including diseases of the digestive, musculoskeletal, and genitourinary systems, remain unclear or inconclusive. We aimed to systematically assess the associations between short-term exposure to main air pollutants (fine particulate matter [PM2.5] and ozone) and cause-specific risk of hospital admission in China over a wide spectrum of human diseases.Methods and findingsDaily data on hospital admissions for primary diagnosis of 14 major and 188 minor disease categories in 252 Chinese cities (107 cities in North China and 145 cities in South China) from January 1, 2013, to December 31, 2017, were obtained from the Hospital Quality Monitoring System of China (covering 387 hospitals in North China and 614 hospitals in South China). We applied a 2-stage analytic approach to assess the associations between air pollution and daily hospital admissions. City-specific associations were estimated with quasi-Poisson regression models and then pooled by random-effects meta-analyses. Each disease category was analyzed separately, and the P values were adjusted for multiple comparisons. A total of 117,338,867 hospital admissions were recorded in the study period. Overall, 51.7% of the hospitalized cases were male, and 71.3% were aged <65 years. Robust positive associations were found between short-term PM2.5 exposure and hospital admissions for 7 major disease categories: (1) endocrine, nutritional, and metabolic diseases; (2) nervous diseases; (3) circulatory diseases; (4) respiratory diseases; (5) digestive diseases; (6) musculoskeletal and connective tissue diseases; and (7) genitourinary diseases. For example, a 10-μg/m3 increase in PM2.5 was associated with a 0.21% (95% CI 0.15% to 0.27%; adjusted P < 0.001) increase in hospital admissions for diseases of the digestive system on the same day in 2-pollutant models (adjusting for ozone). There were 35 minor disease categories significantly positively associated with same-day PM2.5 in both single- and 2-pollutant models, including diabetes mellitus, anemia, intestinal infection, liver diseases, gastrointestinal hemorrhage, renal failure, urinary tract calculus, chronic ulcer of skin, and back problems. The association between short-term ozone exposure and respiratory diseases was robust. No safety threshold in the exposure-response relationships between PM2.5 and hospital admissions was observed. The main limitations of the present study included the unavailability of data on personal air pollution exposures.ConclusionsIn the Chinese population during 2013-2017, short-term exposure to air pollution, especially PM2.5, was associated with increased risk of hospitalization for diseases of multiple organ systems, including certain diseases of the digestive, musculoskeletal, and genitourinary systems; many of these associations are important but still not fully recognized. The effect estimates and exposure-response relationships can inform policy making aimed at protecting public health from air pollution in China.

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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