Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Mar 6, 2023
Open Peer Review Period: Mar 6, 2023 - Mar 30, 2023
Date Accepted: May 26, 2023
Date Submitted to PubMed: May 27, 2023
(closed for review but you can still tweet)
Associations between hourly ambient particulate matter air pollution and ambulance emergency calls among 3,022,164 patients: time stratified case-crossover study
ABSTRACT
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.
Objective:
We used ambulance emergency dispatch data and environmental data between 1 January 2013 and 31 December 2019 from the Shenzhen Ambulance Emergency Centre and the National Environmental Monitor Station to conduct a time-stratified case-crossover study design to estimate the associations of air pollutants (i.e., PM2.5, PM10) with all-cause AECs and cause-specific AECs.
Methods:
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 (ORs) with 95% confidence intervals (CIs), adjusted for public holidays, season, time of day, and day of the week, 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 µg/m3) and PM10 (34.0 µg/m3) concentrations in 24 hours was associated with an increased risk of AECs (PM2.5: all-cause, 1.5%, 95% CI, 0.8%-2.2%; cardiovascular diseases, 1.7%, 95% CI, 0.4%-2.9%; respiratory diseases: 2.3%, 95%CI, -0.8%-5.4%; reproductive illnesses, 1.3%, 95% CI, -1.2%-3.9%; PM10: all-cause, 2.2%, 95% CI, 1.5%-3.0%; cardiovascular diseases, 2.2%, 95% CI, 1.1%-3.6%; respiratory illnesses, 2.7%, 95% CI, -0.4%-5.9%; reproductive illnesses, 2.1%, 95% CI, -0.7%-4.7%).
Conclusions:
The risk of AECs increased consistently with increasing concentrations of PM2.5 and PM10, showing a linear relationship without apparent thresholds. Particulate matter air pollution increase was associated with a higher risk of AECs for all causes, cardiovascular, respiratory, and reproductive AECs. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.