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Risk of ambulance services associated with ambient temperature, fine particulate and its constituents.

ABSTRACT: Short-term adverse health effects of constituents of fine particles with aerodynamic diameters less than or equal to 2.5 ?m (PM_2.5) have been revealed. This study aimed to evaluate the real-time health outcome of ambulance services in association with ambient temperature and mass concentrations of total PM_2.5 level and constituents in Kaohsiung City, an industrialized city with the worst air quality in Taiwan. Cumulative 6-day (lag0-5) relative risk (RR) and 95% confidence interval (CI) of daily ambulance services records of respiratory distress, coma and unconsciousness, chest pain, headaches/dizziness/vertigo/fainting/syncope, lying at public, and out-of-hospital cardiac arrest (OHCA) in association with ambient temperature and mass concentrations of total PM_2.5 level and constituents (nitrate, sulfate, organic carbon (OC), and elemental carbon (EC)) from 2006 to 2010 were evaluated using a distributed lag non-linear model with quasi-Poisson function. Ambulance services of chest pain and OHCA were significantly associated with extreme high (30.8 °C) and low (18.2 °C) temperatures, with cumulative 6-day RRs ranging from 1.37 to 1.67 at the reference temperature of 24-25 °C. Daily total PM_2.5 level had significant effects on ambulance services of lying at public and respiratory distress. After adjusting the cumulative 6-day effects of temperature and total PM_2.5 level, RRs of ambulance services of lying at public associated with constituents at 90th percentile versus 25th percentile were 1.35 (95% CI: 1.08, 1.68) for sulfate and 1.20 (95% CI: 1.02, 1.41) for EC, while RR was 1.31 (95% CI: 1.09-1.58) for ambulance services of headache/dizziness/vertigo/fainting/syncope in association with OC at 90th percentile versus 25th percentile. Cause-specific ambulance services had various significant association with daily temperature, total PM_2.5 level, and concentrations of constituents. Elemental carbon may have stronger associations with increased ambulance services than other constituents.

SUBMITTER: Lin YK

PROVIDER: S-EPMC7813819 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Risk of ambulance services associated with ambient temperature, fine particulate and its constituents.

Lin Yu-Kai YK Cheng Chia-Pei CP Kim Ho H Wang Yu-Chun YC

Scientific reports 20210118 1

Short-term adverse health effects of constituents of fine particles with aerodynamic diameters less than or equal to 2.5 μm (PM<sub>2.5</sub>) have been revealed. This study aimed to evaluate the real-time health outcome of ambulance services in association with ambient temperature and mass concentrations of total PM<sub>2.5</sub> level and constituents in Kaohsiung City, an industrialized city with the worst air quality in Taiwan. Cumulative 6-day (lag0-5) relative risk (RR) and 95% confidence ...[more]

PMID: 33462328

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Project description:BackgroundThe association between daily changes in ambient fine particulate matter (PM2.5) and cardiovascular diseases have been well established in mechanistic, epidemiologic and exposure studies. Only a few studies examined the effect of hourly variations in air pollution on triggering cardiovascular events. Whether the current PM2.5 standards can protect vulnerable individuals with chronic cardiovascular diseases remain uncertain.Methodswe conducted a time-stratified, case-crossover study to assess the associations between hourly changes in PM2.5 levels and the vascular disease onset in residents of Tainan City, Taiwan, visiting Emergency Room of Chi Mei Medical Center between January 2006 and December 2016. There were 26,749 cases including 10,310 females (38.5%) and 16,439 males (61.5%) identified. The time of emergency visit was identified as the onset for each case and control cases were selected as the same times on other days, on the same day of the week in the same month and year respectively. Residential address was used to identify the ambient air pollution exposure concentrations from the closest station. Conditional logistic regression with the stepwise selection method was used to estimate adjusted odds ratios (ORs) for the association.ResultsWhen we only included cases occurring at PM2.5>10 μg/m3 and PM2.5>25 μg/m3, very significant ORs could be observed for 10 μg/m3 increases in PM2.5 at 0 and 1 hour, implying fine particulate exposure could promptly trigger vascular disease events. Moreover, a very clear increase in risk could be observed with cumulative exposure from 0 to 48 hours, especially in those cases where PM2.5>25 μg/m3.ConclusionsOur study demonstrated that transient and low concentrations of ambient PM2.5 trigger adult vascular disease events, especially cerebrovascular disease, regardless of age, sex, and exposure timing. Warning and delivery systems should be setup to protect people from these prompt adverse health impacts.

Project description:BackgroundEvidences have shown that the stroke risk associated with long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) varies among people in North America, Europe and Asia, but studies in Asia rarely evaluated the association by stroke type. We examined whether long-term exposure to PM2.5 is associated with developing all strokes, ischemic stroke and hemorrhagic stroke.MethodsThe retrospective cohort study consisted of 1,362,284 adults identified from beneficiaries of a universal health insurance program in 2011. We obtained data on air pollutants and meteorological measurements from air quality monitoring stations across Taiwan in 2010-2015. Annual mean levels of all environmental measurements in residing areas were calculated and assigned to cohort members. We used Cox proportional hazards models to estimate hazard ratio (HR) and 95% confidence interval (CI) of developing stroke associated with 1-year mean levels of PM2.5 at baseline in 2010, and yearly mean levels from 2010 to 2015 as the time-varying exposure, adjusting for age, sex, income and urbanization level.ResultsDuring a median follow-up time of 6.0 years, 12,942 persons developed strokes, 9919 (76.6%) were ischemic. The adjusted HRs (95% CIs) per interquartile range increase in baseline 1-year mean PM2.5 were 1.03 (1.00-1.06) for all stroke, 1.06 (1.02-1.09) for ischemic stroke, and 0.95 (0.89-1.10) for hemorrhagic stroke. The concentration-response curves estimated in the models with and without additional adjustments for other environmental measurements showed a positively linear association between baseline 1-year mean PM2.5 and ischemic stroke at concentrations greater than 30 μg/m3, under which no evidence of association was observed. There was an indication of an inverse association between PM2.5 and hemorrhagic stroke, but the association no longer existed after controlling for nitrogen dioxide or ozone. We found similar shape of the concentration-response association in the Cox regression models with time-varying PM2.5 exposures.ConclusionLong-term exposure to PM2.5 might be associated with increased risk of developing ischemic stroke. The association with high PM2.5 concentrations remained significant after adjustment for other environmental factors.

Project description:BackgroundExposure to fine particulate matter (PM2.5), an ambient air pollutant with mass-based standards promulgated under the Clean Air Act, and black carbon (BC), a common component of PM2.5, are both associated with cardiovascular health effects.ObjectivesTo elucidate whether BC is associated with distinct, or stronger, cardiovascular responses compared to PM2.5, we conducted a systematic review. We evaluated the associations of short- and long-term BC, or the related component elemental carbon (EC), with cardiovascular endpoints including heart rate variability, heart rhythm, blood pressure and vascular function, ST segment depression, repolarization abnormalities, atherosclerosis and heart function, in the context of what is already known about PM2.5.Data sourcesWe conducted a stepwise systematic literature search of the PubMed, Web of Science and TOXLINE databases and applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines for reporting our results.Study eligibility criteriaStudies reporting effect estimates for the association of quantitative measurements of ambient BC (or EC) and PM2.5, with relevant cardiovascular endpoints (i.e. meeting inclusion criteria) were included in the review. Included studies were evaluated for risk of bias in study design and results.Study appraisal and synthesis methodsRisk of bias evaluations assessed aspects of internal validity of study findings based on study design, conduct, and reporting to identify potential issues related to confounding or other biases. Study results are presented to facilitate comparison of the consistency of associations with PM2.5 and BC within and across studies.ResultsOur results demonstrate similar associations for BC (or EC) and PM2.5 with the cardiovascular endpoints examined. Across studies, associations for BC and PM2.5 varied in their magnitude and precision, and confidence intervals were generally overlapping within studies. Where differences in the magnitude of the association between BC or EC and PM2.5 within a study could be discerned, no consistent pattern across the studies examined was apparent.LimitationsWe were unable to assess the independence of the effect of BC, relative the effect of PM2.5, on the cardiovascular system, nor was information available to understand the impact of differential exposure misclassification.ConclusionsOverall, the evidence indicates that both BC (or EC) and PM2.5 are associated with cardiovascular effects but the available evidence is not sufficient to distinguish the effect of BC (or EC) from that of PM2.5 mass.

Project description:BackgroundNumerous studies have linked fine particles [? 2.5 µm in aerodynamic diameter (PM(2.5))] and health. Most studies focused on the total mass of the particles, although the chemical composition of the particles varies substantially. Which chemical components of fine particles that are the most harmful is not well understood, and research on the chemical composition of PM(2.5) and the components that are the most harmful is particularly limited in Asia.ObjectivesWe characterized PM(2.5) chemical composition and estimated the effects of cause-specific mortality of PM(2.5) mass and constituents in Seoul, Korea. We compared the chemical composition of particles to those of the eastern and western United States.MethodsWe examined temporal variability of PM(2.5) mass and its composition using hourly data. We applied an overdispersed Poisson generalized linear model, adjusting for time, day of week, temperature, and relative humidity to investigate the association between risk of mortality and PM(2.5) mass and its constituents in Seoul, Korea, for August 2008 through October 2009.ResultsPM(2.5) and chemical components exhibited temporal patterns by time of day and season. The chemical characteristics of Seoul's PM(2.5) were more similar to PM(2.5) found in the western United States than in the eastern United States. Seoul's PM(2.5) had lower sulfate (SO(4)) contributions and higher nitrate (NO(3)) contributions than that of the eastern United States, although overall PM(2.5) levels in Seoul were higher than in the United States. An interquartile range (IQR) increase in magnesium (Mg) (0.05 ?g/m³) was associated with a 1.4% increase (95% confidence interval: 0.2%, 2.6%) in total mortality on the following day. Several components that were among the largest contributors to PM(2.5) total mass--NO(3), SO(4), and ammonium (NH(4))--were moderately associated with same-day cardiovascular mortality at the p < 0.10 level. Other components with smaller mass contributions [Mg and chlorine (Cl)] exhibited moderate associations with respiratory mortality on the following day (p < 0.10).ConclusionsOur findings link PM(2.5) constituents with mortality and have implications for policy making on sources of PM(2.5) and on the relevance of PM(2.5) health studies from other areas to this region.

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Risk of ambulance services associated with ambient temperature, fine particulate and its constituents.

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Risk of ambulance services associated with ambient temperature, fine particulate and its constituents.

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