Associations Between Hourly Ambient Particulate Matter Air Pollution and Ambulance Emergency Calls: Time-Stratified Case-Crossover Study

Zhou, Qiang1; Shi, Hanxu2; Wu, Rengyu1; Zhu, Hong1; Qin, Chongzhen1; Liang, Zhisheng2; Sun, Shengzhi3; Zhao, Junfeng4; Wang, Yasha5; Huang, Jie6; Jin, Yinzi2,7; Zheng, Zhijie2; Li, Jingyan8; Zhang, Zhenyu2,7,9

2023

10.2196/47022

JMIR PUBLIC HEALTH AND SURVEILLANCE   影响因子和分区

2369-2960

Background: Associations between short-term exposure to ambient particulate matter (PM) air pollutants and mortality or hospital admissions have been well-documented in previous studies. Less is known about the associations of hourly exposure to PM air pollutants with ambulance emergency calls (AECs) for all causes and specific causes by conducting a case-crossover study. In addition, different patterns of AECs may be attributed to different seasons and daytime or nighttime periods. Objective: In this study, we quantified the risk of all-cause and cause-specific AECs associated with hourly PM air pollutants between January 1, 2013, and December 31, 2019, in Shenzhen, China. We also examined whether the observed associations of PM air pollutants with AECs for all causes differed across strata defined by sex, age, season, and the time of day. Methods: We used ambulance emergency dispatch data and environmental data between January 1, 2013, and December 31, 2019, from the Shenzhen Ambulance Emergency Centre and the National Environmental Monitor Station to conduct a time-stratified case-crossover study to estimate the associations of air pollutants (ie, PM with an aerodynamic diameter less than 2.5 & mu;m [PM2.5] or 10 & mu;m [PM10]) with all-cause and cause-specific AECs. We generated a well-established, distributed lag nonlinear model for nonlinear concentration response and nonlinear lag-response functions. We used conditional logistic regression to estimate odds ratios with 95% CIs, adjusted for public holidays, season, the time of day, the day of the week, hourly temperature, and hourly humidity, to examine the association of all-cause and cause-specific AECs with hourly air pollutant concentrations. Results: A total of 3,022,164 patients were identified during the study period in Shenzhen. Each IQR increase in PM2.5 (24.0 & mu;g/m3) and PM10 (34.0 & mu;g/m3) concentrations over 24 hours was associated with an increased risk of AECs (PM2.5: all-cause, 1.8%, 95% CI 0.8%-2.4%; PM10: all-cause, 2.0%, 95% CI 1.1%-2.9%). We observed a stronger association of all-cause AECs with PM2.5 and PM10 in the daytime than in the nighttime (PM2.5: daytime, 1.7%, 95% CI 0.5%-3.0%; nighttime, 1.4%, 95% CI 0.3%-2.6%; PM10: daytime, 2.1%, 95% CI 0.9%-3.4%; nighttime, 1.7%, 95% CI 0.6%-2.8%) and in the older group than in the younger group (PM2.5: 18-64 years, 1.4%, 95% CI 0.6%-2.1%; & GE;65 years, 1.6%, 95% CI 0.6%-2.6%; PM10: 18-64 years, 1.8%, 95% CI 0.9%-2.6%; & GE;65 years, 2.0%, 95% CI 1.1%-3.0%). Conclusions: The risk of all-cause AECs increased consistently with increasing concentrations of PM air pollutants, showing a nearly linear relationship with no apparent thresholds. PM air pollution increase was associated with a higher risk of all-cause AECs and cardiovascular diseases-, respiratory diseases-, and reproductive illnesses-related AECs. The results of this study may be valuable to air pollution attributable to the distribution of emergency resources and consistent air pollution control.

particulate matter air pollution ambulance emergency calls AECs environmental epidemiology public health air pollution environmental data patient data

SCI ; SSCI

英语

通讯

Sanming Project of Medicine in Shenzhen[SZSM201911005] ; National Key Research and Development Program of China[2022YFC3703003]

Public, Environmental & Occupational Health

Public, Environmental & Occupational Health

WOS:001019004900001

JMIR PUBLICATIONS, INC

Web of Science

1.Shenzhen Ctr Prehosp Care, Shenzhen, Peoples R China
2.Peking Univ, Sch Publ Hlth, Dept Global Hlth, Beijing, Peoples R China
3.Capital Med Univ, Sch Publ Hlth, Beijing, Peoples R China
4.Peking Univ, Sch Comp Sci, Beijing, Peoples R China
5.Peking Univ, Natl Engn Res Ctr Software Engn, Beijing, Peoples R China
6.Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, Shenzhen, Peoples R China
7.Peking Univ, Inst Global Hlth & Dev, Beijing, Peoples R China
8.China Natl Environm Monitoring Ctr, Beijing, Peoples R China
9.Southern Univ Sci & Technol, Peking Univ, Sch Publ Hlth, Dept Global Hlth, Beijing 100191, Peoples R China

Zhou, Qiang,Shi, Hanxu,Wu, Rengyu,et al. Associations Between Hourly Ambient Particulate Matter Air Pollution and Ambulance Emergency Calls: Time-Stratified Case-Crossover Study[J]. JMIR PUBLIC HEALTH AND SURVEILLANCE,2023,9.

Zhou, Qiang.,Shi, Hanxu.,Wu, Rengyu.,Zhu, Hong.,Qin, Chongzhen.,...&Zhang, Zhenyu.(2023).Associations Between Hourly Ambient Particulate Matter Air Pollution and Ambulance Emergency Calls: Time-Stratified Case-Crossover Study.JMIR PUBLIC HEALTH AND SURVEILLANCE,9.

Zhou, Qiang,et al."Associations Between Hourly Ambient Particulate Matter Air Pollution and Ambulance Emergency Calls: Time-Stratified Case-Crossover Study".JMIR PUBLIC HEALTH AND SURVEILLANCE 9(2023).