The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Outcome Ascertainment
2.3. Air Pollutant Exposure Ascertainment and Covariates
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All | Vascular Disease | Respiratory Disease | Reproductive Illness | Injury | Others a | |
---|---|---|---|---|---|---|
Cases | 3,022,164 | 636,288 | 137,960 | 208,408 | 1,324,656 | 714,852 |
Age, years | ||||||
Less than 20 | 185,152 (6.1) | 35,412 (5.6) | 19,836 (14.4) | 8172 (3.9) | 84,764 (6.4) | 36,968 (5.2) |
20 to 64 | 2,462,968 (81.5) | 437,064 (68.7) | 68,252 (49.5) | 193,904 (93.0) | 1,130,360 (85.3) | 633,388 (88.6) |
Equal or more than 65 | 373,884 (12.4) | 163,796 (25.7) | 49,852 (36.1) | 6304 (3.1) | 109,464 (8.3) | 44,468 (6.2) |
Sex | ||||||
Male | 1,942,832 (64.3) | 372,092 (58.5) | 80,760 (58.5) | 46,016 (22.1) | 920,836 (69.5) | 523,128 (73.2) |
Female | 1,079,256 (35.7) | 264,188 (41.5) | 57,196 (41.5) | 162,380 (77.9) | 403,780 (30.5) | 191,712 (26.8) |
Cases by year | ||||||
2013 | 355,816 (11.8) | 70,340 (11.1) | 15,172 (11.0) | 26,784 (12.9) | 168,940 (12.8) | 74,580 (10.4) |
2014 | 385,232 (12.7) | 76,648 (12.0) | 15,804 (11.5) | 29,292 (14.1) | 179,432 (13.5) | 84,056 (11.8) |
2015 | 399,756 (13.2) | 83,152 (13.0) | 16,760 (12.1) | 26,704 (12.8) | 185,484 (14.0) | 87,656 (12.3) |
2016 | 429,948 (14.2) | 90,872 (14.3) | 19,704 (14.3) | 30,792 (14.7) | 192,880 (14.6) | 95,700 (13.4) |
2017 | 465,060 (15.4) | 96,648 (15.2) | 20,748 (15.0) | 31,232 (15.0) | 204,800 (15.5) | 111,632 (15.6) |
2018 | 475,104 (15.7) | 102,792 (16.2) | 22,464 (16.3) | 31,248 (15.0) | 196,036 (14.7) | 122,564 (17.1) |
2019 | 511,248 (17.0) | 115,836 (18.2) | 27,308 (19.8) | 32,356 (15.5) | 197,084 (14.9) | 138,664 (19.4) |
Time of day b | ||||||
Daytime | 1,553,480 (51.4) | 381,668 (60.0) | 77,084 (55.9) | 79,484 (38.1) | 711,324 (53.7) | 219,124 (30.7) |
Nighttime | 1,468,684 (48.6) | 254,620 (40.0) | 60,876 (44.1) | 128,924 (61.9) | 613,332 (46.3) | 495,728 (69.3) |
Pollutants, μg/m3 | ||||||
PM2.5 | 30.1 ± 18.7 | 30.0 ± 18.6 | 29.4 ± 18.5 | 29.5 ± 18.4 | 29.7 ± 18.4 | 29.9 ± 18.5 |
PM10 | 49.3 ± 27.1 | 49.2 ± 27.1 | 48.5 ± 26.9 | 48.5 ± 26.7 | 48.9 ± 26.6 | 49.2 ± 27.0 |
Ozone | 60.5 ± 24.6 | 60.6 ± 24.7 | 60.4 ± 24.9 | 60.4 ± 24.9 | 60.4 ± 24.8 | 60.6 ± 24.8 |
NO2 | 32.0 ± 12.4 | 31.9 ± 12.3 | 31.7 ± 12.4 | 31.6 ± 12.2 | 32.0 ± 12.4 | 31.9 ± 12.3 |
SO2 | 19.7 ± 10.0 | 19.7 ± 10.0 | 19.3 ± 9.9 | 19.3 ± 9.8 | 19.6 ± 9.9 | 19.6 ± 9.9 |
Meteorology | ||||||
Temperature, °C | 23.4 ± 5.8 | 23.5 ± 5.8 | 23.6 ± 5.8 | 23.5 ± 5.8 | 23.9 ± 5.7 | 23.4 ± 5.8 |
Relative humidity, % | 69.8 ± 14.9 | 69.4 ± 14.9 | 69.2 ± 14.7 | 71.0 ± 14.4 | 68.8 ± 14.9 | 70.1 ± 14.7 |
Ambulance Emergency Calls | Effect of Mixtures ψ (log RR, %) | ERR (%) | 95% CI (%) | p-Value |
---|---|---|---|---|
All-cause | 1.65 | 1.67 | (0.12, 3.22) | 0.03 |
Vascular disease | 1.79 | 1.81 | (0.25, 3.39) | 0.02 |
Respiratory disease | 2.22 | 2.25 | (−0.15, 4.70) | 0.07 |
Reproductive illness | 1.75 | 1.77 | (0.44, 3.11) | 0.008 |
Injury | 2.10 | 2.12 | (0.56, 3.71) | 0.008 |
Subgroups | All-Cause | Vascular Disease | Respiratory Disease | Reproductive Illness | Injury |
---|---|---|---|---|---|
ERR, % (95% CI, %) | ERR, % (95% CI, %) | ERR, % (95% CI, %) | ERR, % (95% CI, %) | ERR, % (95% CI, %) | |
Sex | |||||
Male | 1.62 (0.36, 2.87) | 1.74 (−0.23, 3.72) | 2.13 (−0.51, 4.78) | - | 1.96 (−1.42, 5.31) |
Female | 1.63 (0.16, 3.11) | 1.75 (0.20, 3.31) | 2.14 (1.31, 2.92) | 1.79 (−0.84, 4.17) | 2.02 (−0.81, 4.69) |
Age group, years | |||||
Less than 20 | 1.61 (0.79, 2.42) | - | 2.14 (0.00, 4.14) | 1.79 (−0.47, 4.05) | 1.92 (−1.30, 5.15) |
20 to 64 | 1.61 (0.0, 3.30) | 1.77 (0.00, 3.51) | 2.12 (−0.11, 4.38) | 1.77 (−1.33, 4.91) | 1.90 (−2.80, 6.78) |
Equal or more than 65 | 1.89 (0.17, 3.62) | 1.87 (0.00, 3.82) | 2.23 (−0.74, 5.16) | - | 1.99 (0.02, 3.61) |
Season | |||||
Warm | 3.06 (1.44, 4.58) | 3.16 (1.00, 5.33) | 3.03 (0.75, 5.20) | 2.99 (0.42, 5.55) | 3.83 (0.72, 6.91) |
Cool | 0.91 (−1.36, 3.22) | 1.29 (−0.81, 3.39) | 1.57 (−0.50, 3.62) | 0.92 (−1.85, 3.68) | 1.38 (−3.70, 6.35) |
Time of day | |||||
Daytime | 1.84 (−0.31, 3.98) | 2.00 (0.42, 3.56) | 2.53 (0.81, 4.26) | 2.21 (−0.81, 5.23) | 1.92 (−1.62, 5.40) |
Nighttime | 1.41 (−0.27, 3.10) | 1.48 (−1.03, 3.99) | 1.91 (−1.64, 5.47) | 1.56 (−1.52, 4.65) | 2.55 (−1.70, 6.72) |
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Shi, H.; Zhou, Q.; Zhang, H.; Sun, S.; Zhao, J.; Wang, Y.; Huang, J.; Jin, Y.; Zheng, Z.; Wu, R.; et al. The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study. Toxics 2023, 11, 895. https://doi.org/10.3390/toxics11110895
Shi H, Zhou Q, Zhang H, Sun S, Zhao J, Wang Y, Huang J, Jin Y, Zheng Z, Wu R, et al. The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study. Toxics. 2023; 11(11):895. https://doi.org/10.3390/toxics11110895
Chicago/Turabian StyleShi, Hanxu, Qiang Zhou, Hongjuan Zhang, Shengzhi Sun, Junfeng Zhao, Yasha Wang, Jie Huang, Yinzi Jin, Zhijie Zheng, Rengyu Wu, and et al. 2023. "The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study" Toxics 11, no. 11: 895. https://doi.org/10.3390/toxics11110895