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Int. J. Environ. Res. Public Health 2017, 14(4), 423; doi:10.3390/ijerph14040423

Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China

1
Department of Respiratory Medicine, First Hospital, Health Sciences Centre, Peking University, 8 Xishiku Rd., Beijing 100034, China
2
Department of Hospital Information, First Hospital, Health Sciences Centre, Peking University, 8 Xishiku Rd., Beijing 100034, China
3
State Key Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering and Centre for Environment and Health, Peking University, Beijing 100871, China
*
Author to whom correspondence should be addressed.
Academic Editor: Jason K. Levy
Received: 12 February 2017 / Revised: 7 April 2017 / Accepted: 11 April 2017 / Published: 14 April 2017
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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 PM2.5–10 (coarse particulate matter), PM2.5 (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-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 μg/m3 increase in PM2.5 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). PM2.5–10 and NO2 also showed significant associations with OHCAs, whereas SO2, CO, and O3 had no effects. After simultaneously adjusting for NO2 and SO2 in a multi-pollutant model, PM2.5 remained significant. The effects of PM2.5 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 PM2.5 exposure contributes to triggering OHCA, especially in those who are advanced in age and have a history of stroke. View Full-Text
Keywords: air pollution; out-of-hospital cardiac arrest; case-crossover study; Beijing; fine particulate matter air pollution; out-of-hospital cardiac arrest; case-crossover study; Beijing; fine particulate matter
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MDPI and ACS Style

Xia, R.; Zhou, G.; Zhu, T.; Li, X.; Wang, G. Ambient Air Pollution and Out-of-Hospital Cardiac Arrest in Beijing, China. Int. J. Environ. Res. Public Health 2017, 14, 423.

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