Short-term effects of air pollution on out-of-hospital cardiac arrest in Shenzhen, China

Dai, Xiayun; He, Xiaosheng; Zhou, Zhiming; Chen, Jingquan; Wei, Sheng; Chen, Renjie; Yang, Binyao; Feng, Wei; Shan, Aijun; Wu, Tangchun; Guo, Huan

doi:10.1016/j.ijcard.2015.05.016

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…Despite some null results in the literature, 10 significant positive associations between CO and OHCA have been documented 7,23,24,27 and associations with SO 2 have also been observed. [27][28][29] Growing evidence of links between ozone (O 3 ) and OHCA have been observed in several case-crossover or time-series studies. 9,12,13,[28][29][30] A study in Stockholm only found shortterm effects of O 3 on OHCA but not for other air pollutants including PM 2•5 .…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29] Growing evidence of links between ozone (O 3 ) and OHCA have been observed in several case-crossover or time-series studies. 9,12,13,[28][29][30] A study in Stockholm only found shortterm effects of O 3 on OHCA but not for other air pollutants including PM 2•5 . 12 Reasons could include the differences in concentration and composition of air pollutants, study design, and characteristics of study participants.…”

Section: Discussionmentioning

confidence: 99%

“…Five studies have shown null results, in which average NO 2 levels were less than 13 ppb in three studies and the other two showed median NO 2 of 3 ppb and 27 ppb. [7][8][9]23,24 However, increased risks from acute NO 2 exposure on OHCA were observed in Chinese cities 22,29 and in South Korea, 27 where the average NO 2 levels were greater than 17 ppb. The discrepancies across these studies indicate the possibility of a threshold concentration with short-term exposure to NO 2 and OHCA onset.…”

Section: Discussionmentioning

confidence: 99%

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Short-term exposure to ambient fine particulate matter and out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Zhao

Johnston

Salimi

et al. 2020

The Lancet Planetary Health

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Background PM 2•5 is an important but modifiable environmental risk factor, not only for pulmonary diseases and cancers, but for cardiovascular health. However, the evidence regarding the association between air pollution and acute cardiac events, such as out-of-hospital cardiac arrest (OHCA), is inconsistent, especially at concentrations lower than the WHO daily guideline (25 µg/m³). This study aimed to determine the associations between exposure to ambient air pollution and the incidence of OHCA.Methods In this nationwide case-crossover study, we linked prospectively collected population-based registry data for OHCA in Japan from Jan 1, 2014, to Dec 31, 2015, with daily PM 2•5 , carbon monoxide (CO), nitrogen dioxide (NO 2 ), photochemical oxidants (O x ), and sulphur dioxide (SO 2 ) exposure on the day of the arrest (lag 0) or 1-3 days before the arrest (lags 1-3), as well as the moving average across days 0-1 and days 0-3. Daily exposure was calculated by averaging the measurements from all PM 2•5 monitoring stations in the same prefecture. The effect of PM 2•5 on risk of all-cause or cardiac OHCA was estimated using a time-stratified case-crossover design coupled with conditional logistic regression analysis, adjusted for daily temperature and relative humidity. Single-pollutant models were also investigated for the individual gaseous pollutants (CO, NO 2 , O x , and SO 2 ), as well as two-pollutant models for PM 2•5 with these gaseous pollutants. Subgroup analyses were done by sex and age. FindingsOver the 2 years, 249 372 OHCAs were identified, with 149 838 (60•1%) presumed of cardiac origin. The median daily PM 2•5 was 11•98 µg/m³ (IQR 8•13-17•44). Each 10 µg/m³ increase in PM 2•5 was associated with increased risk of all-cause OHCA on the same day (odds ratio [OR] 1•016, 95% CI 1•009-1•023) and at lags of up to 3 days, ranging from OR 1•015 (1•008-1•022) at lag 1 to 1•033 (1•023-1•043) at lag 0-3. Results for cardiac OHCA were similar (ORs ranging from 1•016 [1•007-1•025] at lags 1 and 2 to 1•034 [1•021-1•047] at lag 0-3). Patients older than 65 years were more susceptible to PM 2•5 exposure than younger age groups but no sex differences were identified. CO, O x , and SO 2 were also positively associated with OHCA while NO 2 was not. However, in two-pollutant models of PM 2•5 and gaseous pollutants, only PM 2•5 (positive association) and NO 2 (negative association) were independently associated with increased risk of OHCA. Interpretation Short-term exposure to PM 2•5 was associated with an increased risk of OHCA even at relatively low concentrations. Regulatory standards and targets need to incorporate the potential health gains from continual air quality improvement even in locations already meeting WHO standards.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Short-term exposure to ambient fine particulate matter and out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Zhao

Johnston

Salimi

et al. 2020

The Lancet Planetary Health

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“…Shenzhen is one of the forefront cities of China's reform and opening and an important center of global technological innovation and electronics industry. Previous studies reported that the average annual number of OHCA cases in Guangzhou and Shenzhen were around 874 and 658, respectively [29,30]. In general, it is necessary to pay attention to the status of AED facilities in such megacities with massive population.…”

Section: Study Areamentioning

confidence: 99%

Observed Equity and Driving Factors of Automated External Defibrillators: A Case Study Using WeChat Applet Data

Liao,

Gao,

Feng

et al. 2023

IJGI

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Out-of-hospital cardiac arrest (OHCA) causes a high mortality rate each year, which is a threat to human well-being and health. An automated external defibrillator (AED) is an effective device for heart attack-related diseases and is a panacea to save OHCA. Most relevant literature focuses on the spatial distribution, accessibility, and configuration optimization of AED devices, which all belong to the characteristics of the spatial distribution of AED devices. Still, there is a lack of discussion on related potential influencing factors. In addition, analysis of AED facilities involving multiple city comparisons is less considered. In this study, data on AED facilities in two major cities in China were obtained through the WeChat applet. Then, the AED equity at the city and block scales and its socioeconomic factors were analyzed using the Gini coefficient, Lorenz curve, and optimal parameters-based geo-graphical detector (OPGD) model. Results show that the number of AEDs in Shenzhen was about eight-times that of in Guangzhou. The distribution of AEDs in Shenzhen was more equitable with a global Gini of 0.347, higher than that in Guangzhou with a global Gini of 0.504. As for the determinants of AED equity, residential density was the most significant determinant in both Guangzhou and Shenzhen from the perspective of individual effects on AED equity. Differently, due to the aging population in Guangzhou, the proportion of the elderly in blocks was influential to local AED equity. The local economic development level was crucial to local AED equity in Shenzhen. The results of the interaction detector model illustrate that relatively equitable AED distributions were found in the high-density residential areas with a balance of employment and housing, high-aging residential areas, and high-mobility residential areas in Guangzhou. The area with a high level of local economic development, dense population, and large mobility was the area with a relatively equitable distribution of AEDs in Shenzhen. The results of this paper are conducive to understanding the equity of AEDs and its socio-economic determinants, providing scientific reference for the optimization and management of AEDs.

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Time series analysis of ambient air pollution effects on daily mortality

Guo

Zhang

et al. 2017

Environ Sci Pollut Res

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Although the growths of ambient pollutants have been attracting public concern, the characteristic of the associations between air pollutants and mortality remains elusive. Time series analysis with a generalized additive model was performed to estimate the associations between ambient air pollutants and mortality outcomes in Shenzhen City for the period of 2012-2014. The results showed that nitrogen dioxide (NO)-induced excess risks (ER) of total non-accidental mortality and cardiovascular mortality were significantly increased (6.05% (95% CI 3.38%, 8.78%); 6.88% (95% CI 2.98%, 10.93%), respectively) in interquartile range (IQR) increase analysis. Also, these associations were strengthened after adjusting for other pollutants. Moreover, similar associations were estimated for sulfur dioxide (SO), particulate matter with an aerodynamic diameter of <10 μm (PM), and total non-accidental mortality. There were significant higher ERs of associations between PM and mortality for men than women; while there were significant higher ERs of associations between PM/NO and mortality for elders (65 or elder) than youngers (64 or younger). Season analyses showed that associations between NO and total non-accidental mortality were more pronounced in hot seasons than in warm seasons. Taken together, NO was positively associated with total non-accidental mortality and cardiovascular mortality in Shenzhen even when the concentrations were below the ambient air quality standard. Policy measures should aim at reducing residents' exposure to anthropogenic NO emissions.

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Short-term effects of air pollution on out-of-hospital cardiac arrest in Shenzhen, China

Cited by 9 publications

References 10 publications

Short-term exposure to ambient fine particulate matter and out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Short-term exposure to ambient fine particulate matter and out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Observed Equity and Driving Factors of Automated External Defibrillators: A Case Study Using WeChat Applet Data

Time series analysis of ambient air pollution effects on daily mortality

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