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Du X, Chen R, Kan H. Challenges of Air Pollution and Health in East Asia. Curr Environ Health Rep 2024; 11:89-101. [PMID: 38321318 DOI: 10.1007/s40572-024-00433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW Air pollution has been a serious environmental and public health issue worldwide, particularly in Asian countries. There have been significant increases in epidemiological studies on fine particulate matter (PM2.5) and ozone pollution in East Asia, and an in-depth review of epidemiological evidence is urgent. Thus, we carried out a systematic review of the epidemiological research on PM2.5 and ozone pollution in East Asia released in recent years. RECENT FINDINGS Recent studies have indicated that PM2.5 and ozone are the most detrimental air pollutants to human health, resulting in substantial disease burdens for Asian populations. Many epidemiological studies of PM2.5 and ozone have been mainly performed in three East Asian countries (China, Japan, and South Korea). We derived the following summary findings: (1) both short-term and long-term exposure to PM2.5 and ozone could raise the risks of mortality and morbidity, emphasizing the need for continuing improvements in air quality in East Asia; (2) the long-term associations between PM2.5 and mortality in East Asia are comparable to those observed in Europe and North America, whereas the short-term associations are relatively smaller in magnitude; and (3) further cohort and intervention studies are required to yield robust and precise evidence that can promote evidence-based policymaking in East Asia. This updated review presented an outline of the health impacts of PM2.5 and ozone in East Asia, which may be beneficial for the development of future regulatory policies and standards, as well as for designing subsequent investigations.
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Affiliation(s)
- Xihao Du
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China.
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
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Michikawa T, Sasaki J, Yamazaki S, Takami A, Asakura K, Imamura H, Ueda K, Saito S, Hoshi J, Yoshino A, Sugata S, Nitta H, Nishiwaki Y. A Case-Crossover Analysis of the Association between Exposure to Total PM 2.5 and Its Chemical Components and Emergency Ambulance Dispatches in Tokyo. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7319-7327. [PMID: 35608996 DOI: 10.1021/acs.est.1c08219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A limited number of studies have investigated the association between short-term exposure to PM2.5 components and morbidity. The present case-crossover study explored the association between exposure to total PM2.5 and its components and emergency ambulance dispatches, which is one of the indicators of morbidity, in the 23 Tokyo wards. Between 2016 and 2018 (mean mass concentrations of total PM2.5 13.5 μg/m3), we obtained data, from the Tokyo Fire Department, on the daily cases of ambulance dispatches. Fine particles were collected at a fixed monitoring site and were analyzed to estimate the daily mean concentrations of carbons and ions. We analyzed 1038301 cases of health-based all-cause ambulance dispatches by using a conditional logistic regression model. The average concentrations of total PM2.5 over one and the previous day were positively associated with the number of ambulance dispatches. In terms of PM2.5 components, the percentage increase per interquartile range (IQR) increase was 0.8% for elemental carbon (IQR = 0.8 μg/m3; 95% CI = 0.3-1.3%), 0.9% for sulfate (2.1 μg/m3; 0.5-1.4%), and 1.1% for ammonium (1.3 μg/m3; 0.4-1.8%) in the PM2.5-adjusted models. This is the first study to find an association between some specific components in PM2.5 and ambulance dispatches.
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Affiliation(s)
- Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo160-8582, Japan
| | - Shin Yamazaki
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Akinori Takami
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
| | - Haruhiko Imamura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
- Environmental Health Sciences, Kyoto University Graduate School of Global Environmental Studies, Kyoto Daigaku Katsura, Nishikyo-ku, Kyoto 615-8540, Japan
| | - Shinji Saito
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo136-0075, Japan
| | - Junya Hoshi
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo136-0075, Japan
| | - Ayako Yoshino
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Seiji Sugata
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Hiroshi Nitta
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
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Li Y, Batibawa JW, Du Z, Liang S, Duan J, Sun Z. Acute exposure to PM 2.5 triggers lung inflammatory response and apoptosis in rat. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 222:112526. [PMID: 34303042 DOI: 10.1016/j.ecoenv.2021.112526] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
Severe haze events, especially with high concentration of fine particulate matter (PM2.5), are frequent in China, which have gained increasing attention among public. The purpose of our study was explored the toxic effects and potential damage mechanisms about PM2.5 acute exposure. Here, the diverse dosages of PM2.5 were used to treat SD rats and human bronchial epithelial cell (BEAS-2B) for 24 h, and then the bioassays were performed at the end of exposure. The results show that acute exposure to diverse dosages of PM2.5 could trigger the inflammatory response and apoptosis. The severely oxidative stress may contribute to the apoptosis. Also, the activation of Nrf2-ARE pathway was an important compensatory process of antioxidant damage during the early stage of acute exposure to PM2.5. Furthermore, the HO-1 was suppression by siRNA that promoted cell apoptosis triggered by PM2.5. In other words, enhancing the expression of HO-1 may mitigate the cell apoptosis caused by acute exposure to PM2.5. In summary, our findings present the first time that prevent or mitigate the damage triggered by PM2.5 through antioxidant approaches was a promising strategy.
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Affiliation(s)
- Yang Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Josevata Werelagi Batibawa
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Zhou Du
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Shuang Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
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Wang YC, Sung FC, Chen YJ, Cheng CP, Lin YK. Effects of extreme temperatures, fine particles and ozone on hourly ambulance dispatches. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 765:142706. [PMID: 33071137 DOI: 10.1016/j.scitotenv.2020.142706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/15/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
There is a dearth of research on the hourly risk of ambulance dispatches with respect to ambient conditions. We evaluated hourly relative risks (RR) and 95% confidence interval (CI) of ambulance dispatches in Taiwan to treat respiratory distress, coma and unconsciousness, and out-of-hospital cardiac arrest (OHCA), from 2006 to 2015. We considered island-wide ambient temperatures, fine particulate matter (PM2.5), and ozone (O3) at lag 0-180 h while using a distributed lag nonlinear model and meta-analysis. Results showed the pooled risks peaked at lag 16-18 h for all ambulance dispatches at 99th percentile of hourly temperature (32 °C, versus reference temperature of 25 °C), with significant excess risk of 0.11% (95% CI; 0.06, 0.17) for coma and unconsciousness, and 0.06% (95% CI; 0.01, 0.11) for OHCA. The risks of exposure to 90th percentile of hourly O3 of 52.3 ppb relative to the Q1 level of 17.3 ppb peaked at lag 14 h, with excess risk of 0.17% (95% CI; 0.11, 0.23) for respiratory distress, 0.11% (95% CI; 0.06, 0.16) for coma and unconsciousness, and 0.07% (95% CI; 0.01, 0.14) for OHCA. The population exposed to reference temperatures of 28 °C, 20 °C, and 26 °C were exposed to the lowest levels of ambulance dispatches risk for respiratory distress, coma and unconsciousness, and OHCA, respectively; the highest cumulative 0-96 h RRs of ambulance dispatches were 1.27 (95% CI; 1.19, 1.35) for OHCA at 5th percentile temperatures and 1.25 (95% CI; 1.11, 1.41) for OHCA at 99th percentile temperatures. Following an accumulating lag of 0-96 h, no significant risk was identified for hourly levels of PM2.5 and O3. In conclusion, the analytical results of hourly data speak to immediate and real-time responses to environmental changes, rather than to short-term relationships. In our analyses, we emphasized health events in extreme heat; thus, we recommend a comparative study of daily versus hourly associations.
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Affiliation(s)
- Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan; Department of Food Nutrition and Health Biotechnology, Asia University, Taichung 413, Taiwan
| | - Yi-Jhih Chen
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Chia-Pei Cheng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, University of Taipei, 101 Zhongcheng Road Sec. 2, Taipei 111, Taiwan.
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5
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Lin YK, Cheng CP, Kim H, Wang YC. Risk of ambulance services associated with ambient temperature, fine particulate and its constituents. Sci Rep 2021; 11:1651. [PMID: 33462328 PMCID: PMC7813819 DOI: 10.1038/s41598-021-81197-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/05/2021] [Indexed: 11/29/2022] Open
Abstract
Short-term adverse health effects of constituents of fine particles with aerodynamic diameters less than or equal to 2.5 μm (PM2.5) have been revealed. This study aimed to evaluate the real-time health outcome of ambulance services in association with ambient temperature and mass concentrations of total PM2.5 level and constituents in Kaohsiung City, an industrialized city with the worst air quality in Taiwan. Cumulative 6-day (lag0-5) relative risk (RR) and 95% confidence interval (CI) of daily ambulance services records of respiratory distress, coma and unconsciousness, chest pain, headaches/dizziness/vertigo/fainting/syncope, lying at public, and out-of-hospital cardiac arrest (OHCA) in association with ambient temperature and mass concentrations of total PM2.5 level and constituents (nitrate, sulfate, organic carbon (OC), and elemental carbon (EC)) from 2006 to 2010 were evaluated using a distributed lag non-linear model with quasi-Poisson function. Ambulance services of chest pain and OHCA were significantly associated with extreme high (30.8 °C) and low (18.2 °C) temperatures, with cumulative 6-day RRs ranging from 1.37 to 1.67 at the reference temperature of 24–25 °C. Daily total PM2.5 level had significant effects on ambulance services of lying at public and respiratory distress. After adjusting the cumulative 6-day effects of temperature and total PM2.5 level, RRs of ambulance services of lying at public associated with constituents at 90th percentile versus 25th percentile were 1.35 (95% CI: 1.08, 1.68) for sulfate and 1.20 (95% CI: 1.02, 1.41) for EC, while RR was 1.31 (95% CI: 1.09–1.58) for ambulance services of headache/dizziness/vertigo/fainting/syncope in association with OC at 90th percentile versus 25th percentile. Cause-specific ambulance services had various significant association with daily temperature, total PM2.5 level, and concentrations of constituents. Elemental carbon may have stronger associations with increased ambulance services than other constituents.
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Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, University of Taipei College of City Management, 101 Zhongcheng Road Sec. 2, Taipei, 111, Taiwan
| | - Chia-Pei Cheng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Ho Kim
- Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan. .,Research Center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 11529, Taiwan.
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6
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Li M, Tang J, Yang H, Zhao L, Liu Y, Xu H, Fan Y, Hong J, Long Z, Li X, Zhang J, Guo W, Liu M, Yang L, Lai X, Zhang X. Short-term exposure to ambient particulate matter and outpatient visits for respiratory diseases among children: A time-series study in five Chinese cities. CHEMOSPHERE 2021; 263:128214. [PMID: 33297172 DOI: 10.1016/j.chemosphere.2020.128214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 06/12/2023]
Abstract
There was limited evidence regarding the association between short-term exposure to ambient particulate matter (PM) and respiratory outpatient visits among children at a multicity level. In this study, a time-series study was conducted among children aged 0-14 years in five Chinese cities from 2013 to 2018. City-specific effects of fine particles (PM2.5), inhalable particles (PM10) and coarse particles (PM10-2.5) were estimated for time lags of zero up to seven previous days using the overdispersed generalized additive models after adjusting for time trends, meteorological variables, day of the week and holidays. Meta-analyses were applied to pool the overall effects, while the exposure-response (E-R) curves were evaluated using a cubic regression spline. The overall effects of PM were significantly associated with total and cause-specific respiratory outpatients among children, even at PM2.5 and PM10 levels below the current Chinese Ambient Air Quality Standards (CAAQS) Grade II. Each 10 μg/m3 increment in PM2.5, PM10 and PM10-2.5 at lag 07 was associated with a 1.39% (95% CI: 0.38%, 2.40%), 1.10% (95% CI: 0.38%, 1.83%) and 2.93% (95% CI: 1.05%, 4.84%) increase in total respiratory outpatients, respectively. An E-R relationship was observed except for PM2.5 in Beijing and PM10 and PM10-2.5 in Shanghai. The effects of PM were stronger in cold season in 3 southern cities, while it was stronger in transition season in 2 northern cities. In conclusion, short-term PM exposures were dose-responsive associated with increased respiratory outpatient visits among children, even for PM2.5 and PM10 levels below current CAAQS II in certain cities.
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Affiliation(s)
- Meng Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huihua Yang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lei Zhao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Ya Liu
- Department of Medical Record, Beijing Hospital, Beijing, China
| | - Haoli Xu
- Department of Healthcare, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yali Fan
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Jun Hong
- Qinghai Provincial Women and Children's Hospital, Xining, China
| | - Zhen Long
- Department of Pediatric respiratory Medicine, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, HUST, Wuhan, China
| | - Xiaojuan Li
- Department of Medical Record and Statistics, Emergency General Hospital, Beijing, China
| | - Jianduan Zhang
- Department of Woman and Child's Care and Adolescence Health, School of Public Health, Tongji Medical College, HUST, Wuhan, China
| | - Wenting Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Miao Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
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7
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Phung VLH, Ueda K, Seposo X, Takami A, Sugata S, Yoshino A, Michikawa T, Yamazaki S, Honda A, Takano H. Hourly association between ambient PM 2.5 and emergency ambulance dispatches in 11 cities in Japan. ENVIRONMENTAL RESEARCH 2020; 185:109448. [PMID: 32278156 DOI: 10.1016/j.envres.2020.109448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Numerous epidemiological studies have demonstrated that short-term exposure to ambient PM2.5 increases mortality and morbidity. Investigating the association using hourly ambient PM2.5 exposure may provide important insights, as current evidence is limited mostly to daily lag term. This study aimed to investigate the hourly association between ambient PM2.5 concentrations and all-cause emergency ambulance dispatches (EAD) in 11 cities in Japan. We used a time-stratified case-crossover design and examined the hourly lags of ambient PM2.5 up to 24 h (unconditional distributed lags and moving average lags) using a conditional Poisson regression model. A significant increase in all-cause EAD was observed at lag 0 h [relative risk (RR): 1.0037 (95% CI: 1.0000, 1.0074)] and all moving average lags. The highest RR was observed within the first 6 h (at lag 0-5 h) [RR: 1.0091 (95% CI: 1.0068, 1.0114)], with a slight ascending pattern. This was followed by a descending pattern at lags 0-11, 0-17, and 0-23 h, but significant positive RR was observed even at lag 0-23 h, when the lowest RR was observed [RR: 1.0072 (95% CI: 1.0044, 1.0100)]. Though similar pattern was observed among the elderly, a different pattern was observed among the children (gradually ascending pattern). We conclude that all-cause EAD could be triggered by ambient PM2.5 exposure with very short lags.
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Affiliation(s)
- Vera Ling Hui Phung
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan.
| | - Kayo Ueda
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Xerxes Seposo
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Akinori Takami
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies (NIES), Tsukuba, Japan
| | - Seiji Sugata
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies (NIES), Tsukuba, Japan
| | - Ayako Yoshino
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies (NIES), Tsukuba, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Japan
| | - Shin Yamazaki
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies (NIES), Tsukuba, Japan
| | - Akiko Honda
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
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Sangkharat K, Fisher P, Thomas GN, Thornes J, Pope FD. The impact of air pollutants on ambulance dispatches: A systematic review and meta-analysis of acute effects. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 254:112769. [PMID: 31419665 DOI: 10.1016/j.envpol.2019.06.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 06/10/2023]
Abstract
A number of systematic reviews have investigated the association between air pollutants and health impacts, these mostly focus on morbidity and mortality from hospital data. Previously, no reviews focused solely on ambulance dispatch data. These data sets have excellent potential for environmental health research. For this review, publications up to April 2019 were identified using three main search categories covering: ambulance services including dispatches; air pollutants; and health outcomes. From 308 studies initially identified, 275 were excluded as they did not relate to ambulance service dispatches, did not report the air pollutant association, and/or did not study ambient air pollution. The main health outcomes in the remaining 33 studies were cardiac arrest (n = 14), cardiovascular (n = 11) and respiratory (n = 10) dispatches. Meta-analyses were performed to summarise pooled relative risk (RR) of pollutants: particulate matter less than 2.5 and 10 μm (PM2.5, PM10), the fraction between PM10 and PM2.5 (coarse) and suspended particulate matter (SPM) per 10 μg/m3 increase, carbon monoxide (CO) per 1 ppm increase and of sulphur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) per 10 ppb increment and ambulance dispatches. Statistically significant associations were found for ambulance dispatch data for all-respiratory and PM2.5 at 1.03 (95% CI:1.02-1.04) and at 1.10 (95% CI:1.00-1.21) for asthma and NO2 associations. For dispatches with subsequent paramedic assessment for cardiac arrest with PM2.5, CO and coarse dispatches at 1.05 (95% CI:1.03-1.08), 1.10 (95% CI:1.02-1.18) and 1.04 (95% CI:1.01-1.06) respectively. For dispatches with subsequent physician diagnosis for all-respiratory and PM2.5 at 1.02 (95% CI:1.01-1.03). In conclusion, air pollution was significantly associated with an increase in ambulance dispatch data, including those for cardiac arrest, all-respiratory, and asthma dispatches. Ambulance services should plan accordingly during pollution events. Furthermore, efforts to improve air quality should lead to decreases in ambulance dispatches.
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Affiliation(s)
- Kamolrat Sangkharat
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Paul Fisher
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - John Thornes
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK; Chemicals and Environmental Effects, Public Health England, Oxfordshire, UK
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK.
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Aghababaeian H, Dastoorpoor M, Ghasemi A, Kiarsi M, Khanjani N, Araghi Ahvazi L. Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran. J Cardiovasc Thorac Res 2019; 11:264-271. [PMID: 31824607 PMCID: PMC6891034 DOI: 10.15171/jcvtr.2019.44] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 09/15/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS).
Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days.
Results: In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions.
Conclusion: Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.
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Affiliation(s)
- Hamidreza Aghababaeian
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran.,Department of Health in Emergencies and Disaster, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Afsaneh Ghasemi
- Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Kiarsi
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ladan Araghi Ahvazi
- Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, Iran
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Effects of Short-term Exposure to Ambient Particulate Matter on the Lung Function of School Children in Dhaka, Bangladesh. Epidemiology 2019; 30 Suppl 1:S15-S23. [DOI: 10.1097/ede.0000000000001012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Ambient Particulate Matter and Paramedic Assessments of Acute Diabetic, Cardiovascular, and Respiratory Conditions. Epidemiology 2019; 30:11-19. [PMID: 30334919 PMCID: PMC6276863 DOI: 10.1097/ede.0000000000000929] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Ambulance data provide a useful source of population-based and spatiotemporally resolved information for assessing health impacts of air pollution in nonhospital settings. We used the clinical records of paramedics to quantify associations between particulate matter (PM2.5) and diabetic, cardiovascular, and respiratory conditions commonly managed by those responding to calls for emergency ambulance services. Methods: We evaluated 394,217 paramedic assessments from three states in Southeastern Australia (population 13.2 million) and daily PM2.5 concentrations modeled at 5 km resolution from 2009 to 2014. We used a time-stratified, case-crossover analysis adjusted for daily meteorology to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for each clinical outcome per 10 µg/m3 increase in daily PM2.5 at lags from 0 to 2 days. Results: Increased PM2.5 was associated with increased odds of paramedic assessments of hypoglycemia (OR = 1.07; 95% CI = 1.02, 1.12, lag 0), arrhythmia (OR = 1.05; 95% CI = 1.02, 1.09, lag 0), heart failure (OR = 1.07; 95% CI = 1.02, 1.12, lag 1), faint (OR = 1.09; 95% CI = 1.04–1.13, lag 0), asthma (OR = 1.06; 95% CI = 1.01, 1.11, lag 1), chronic obstructive pulmonary disease (OR = 1.07; 95% CI = 1.01, 1.13, lag 1), and croup (OR = 1.09; 95% CI = 1.02, 1.17). We did not identify associations with cerebrovascular outcomes. Conclusions: Ambulance data enable the evaluation of important clinical syndromes that are often initially managed in nonhospital settings. Daily PM2.5 was associated with hypoglycemia, faint, and croup in addition to the respiratory and cardiovascular outcomes that are better established.
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Acute Effects of Ambient PM 2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020307. [PMID: 29425190 PMCID: PMC5858376 DOI: 10.3390/ijerph15020307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 12/23/2022]
Abstract
Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007–2011). Statistical analyses included two stages: (1) City-level generalized linear model with Poisson distribution; (2) Random-effects meta-analysis in pooling city-specific effect estimates. Lag patterns were explored using (1) unconstrained-distributed lags (lag 0 to lag 7) and (2) average lags (lag: 0–1, 0–3, 0–5, 0–7). In all-cause EAD, significant increases were observed in both shorter lag (lag 0: 1.24% (95% CI: 0.92, 1.56)) and average lag 0–1 (0.64% (95% CI: 0.23, 1.06)). Increases of 1.88% and 1.48% in respiratory and neuropsychological EAD outcomes, respectively, were observed at lag 0 per 10 µg/m3 increase in PM2.5. While respiratory outcomes demonstrated significant average effects, no significant effect was observed for cardiovascular outcomes. Meanwhile, an inverse association was observed in cerebrovascular outcomes. In this study, we observed that effects of PM2.5 on all-cause, respiratory and neuropsychological EAD were acute, with average effects not exceeding 3 days prior to EAD onset.
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Kotani K, Ueda K, Seposo X, Yasukochi S, Matsumoto H, Ono M, Honda A, Takano H. Effects of high ambient temperature on ambulance dispatches in different age groups in Fukuoka, Japan. Glob Health Action 2018; 11:1437882. [PMID: 29471745 PMCID: PMC5827789 DOI: 10.1080/16549716.2018.1437882] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/01/2018] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The elderly population has been the primary target of intervention to prevent heat-related illnesses. According to the literature, the highest risks have been observed among the elderly in the temperature-mortality relationship. However, findings regarding the temperature-morbidity relationship are inconsistent. OBJECTIVES This study aimed to examine the association of temperature with ambulance dispatches due to acute illnesses, stratified by age group. Specifically, we explored the optimum temperature, at which the relative health risks were found to be the lowest, and quantified the health risk associated with higher temperatures among different age groups. METHODS We used the data for ambulance dispatches in Fukuoka, Japan, during May and September from 2005 to 2012. The data were grouped according to age in 20-year increments. We explored the pattern of the association of ambulance dispatches with temperature using a smoothing spline curve to identify the optimum temperature for each age group. Then, we applied a distributed lag nonlinear model to estimate the risks of the 85th-95th percentile temperature relative to the overall optimum temperature, for each age group. RESULTS The relative risk of ambulance dispatches at the 85th and 95th percentile temperature for all ages was 1.08 [95% confidence interval (CI): 1.05, 1.12] and 1.12 (95% CI: 1.08, 1.16), respectively. In comparison, among age groups, the optimum temperature was observed as 25.0°C, 23.2°C, and 25.3°C for those aged 0-19, 60-79, and ≥80, respectively. The optimum temperature could not be determined for those aged 20-39 and 40-59. The relative risks of high temperature tended to be higher for those aged 20-39 and 40-59 than those for other age groups. CONCLUSIONS We did not find any definite difference in the effect of high temperature on ambulance dispatches for different age groups. However, more measures should be taken for younger and middle-aged people to avoid heat-related illnesses.
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Affiliation(s)
- Kazuya Kotani
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Kayo Ueda
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Xerxes Seposo
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Shusuke Yasukochi
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Hiroko Matsumoto
- Environmental Science Section, Fukuoka City Institute of Health and Environment, Fukuoka, Japan
| | - Masaji Ono
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Akiko Honda
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
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Vencloviene J, Braziene A, Dedele A, Lopatiene K, Dobozinskas P. Associations of short-term exposure to ambient air pollutants with emergency ambulance calls for the exacerbation of essential arterial hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2017; 27:509-524. [PMID: 29149802 DOI: 10.1080/09603123.2017.1405246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/23/2017] [Indexed: 06/07/2023]
Abstract
We investigated the association between daily emergency ambulance calls (EAC) for elevated blood pressure that occurred during the time intervals of 8:00-13:59, 14:00-21:59, and 22:00-7:59, and exposure to CO, PM10, and ozone. We used Poisson regression to explore the association between the risk of EAC and short-term variation of pollutants, adjusting for seasonality and weather variables. Before noon, the risk was associated with an interquartile range (IQR) (7.9 μg/m3) increase in PM10 at lag 2-4 days below the median (RR = 1.08, p = 0.031) and with an IQR (0.146 mg/m3) increase in CO at lag 6-7 below the median (RR = 1.05, p = 0.028). During 14:00-21:59, the risk was associated with an IQR (18.8 μg/m3) increase in PM10 on the previous day below the median (RR = 1.04, p = 0.031). At night, EAC were negatively affected by lower O3 (lag 0-2) below the median (per IQR decrease RR = 1.10, p = 0.018) and a higher PM10 at lag 0-1 above the median for the elderly (RR = 1.07, p = 0.030).
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Affiliation(s)
- Jone Vencloviene
- a Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania
| | - Agne Braziene
- a Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania
| | - Audrius Dedele
- a Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania
| | - Kristina Lopatiene
- b Department of Orthodontics , Lithuanian University of Health Sciences , Kaunas , Lithuania
| | - Paulius Dobozinskas
- c Department of Disaster Medicine , Lithuanian University of Health Sciences , Kaunas , Lithuania
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15
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Zhou W, Yuan X, Zhang L, Su B, Tian D, Li Y, Zhao J, Wang Y, Peng S. Overexpression of HO-1 assisted PM2.5-induced apoptosis failure and autophagy-related cell necrosis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2017; 145:605-614. [PMID: 28802142 DOI: 10.1016/j.ecoenv.2017.07.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/16/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
Severe smog/haze events accompanied by extremely high concentrations of airborne fine particulate matter (PM2.5) have emerged frequently in China and the potential health risks have attracted ever-growing attention. During these episodes, a surge in hospital visits for acute respiratory symptoms and respiratory diseases exacerbation has been reported to be associated with acute exposure to high-levels of particulate matters. To investigate cell fate determination and the underlying pathogenic mechanisms during severe haze episodes or smog events, we exposed human lung epithelial cells (BEAS-2B) to PM2.5 (0-400μg/mL) for 24h and found that high doses of PM2.5 caused cell necrosis and autophagy dysfunction, while co-treatment with the autophagy inhibitor 3-MA could partially reduce PM2.5-induced cell necrosis. Exposure to PM2.5 also increased the expression and mitochondrial transposition of heme oxygenase 1 (HO-1), which consequently reduced the release of cytochrome C from mitochondria to cytosol. Knockdown of HO-1 by siRNA attenuated the mitochondrial accumulation of HO-1, reversed HO-1-induced the reduction of cytochrome C release and promoted PM2.5-induced cell apoptosis. In contrast to necrosis, PM2.5-induced autophagy was independent of HO-1. In conclusion, our results demonstrate that acute exposure to high PM2.5 concentrations causes autophagy-related cell necrosis. The decrease in cytochrome C release and apoptosis by upregulation of HO-1 maybe assist PM2.5-induced autophagy-related cell necrosis. Further, this study reveals dual roles for HO-1 in PM2.5-induced cytotoxicity and presents a possible explanation for the onset of acute respiratory symptoms under extreme particulate air pollution.
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Affiliation(s)
- Wei Zhou
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Xiaoyan Yuan
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Li Zhang
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Baoting Su
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China; Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Dongdong Tian
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Yang Li
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Jun Zhao
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China
| | - Yimei Wang
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China.
| | - Shuangqing Peng
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing 100071, PR China.
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Liu R, Zeng J, Jiang X, Chen J, Gao X, Zhang L, Li T. The relationship between airborne fine particle matter and emergency ambulance dispatches in a southwestern city in Chengdu, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 229:661-667. [PMID: 28697471 DOI: 10.1016/j.envpol.2017.06.098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 06/07/2023]
Abstract
High levels of fine particulate matter (PM2.5) are known to cause adverse effects to human health. The goal of this study was to estimate the acute health effects of short-term exposure to ambient PM2.5 by analyzing cause-specific emergency ambulance dispatches as the endpoint in Chengdu, a city in Sichuan Province in southwest China. The ambient PM2.5 concentration of Chengdu reached 63 μg/m3 in 2015. Data related to the causes of specific emergency ambulance dispatches, air pollution, and meteorological conditions were collected from 2013 to 2015 (1095 days). A generalized additive model (GAM) was constructed to control the confounding conditions and to estimate the effects of PM2.5 on human health conditions. Emergency ambulance dispatches for all causes with (RR for lag0 = 1.0010, 95%CI: 1.0002, 1.0019) or without injuries (RR for lag0 = 1.0012, 95%CI: 1.0002, 1.0022), respiratory diseases (RR for lag0 = 1.0051, 95%CI: 1.0012, 1.0089), and cardiovascular diseases (RR for lag0 = 1.0041, 95%CI: 1.0009, 1.0074) were associated with ambient PM2.5 concentrations in Chengdu. In addition, the effects of PM2.5 were not confounded by ozone.
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Affiliation(s)
- Ruicong Liu
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Jie Zeng
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No. 4, Longxiang Road, Wuhou District, Chengdu 610041, China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China.
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7, South Panjiayuan, Chaoyang District, Beijing 100021, China.
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17
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Ichiki T, Onozuka D, Kamouchi M, Hagihara A. An association between fine particulate matter (PM2.5) levels and emergency ambulance dispatches for cardiovascular diseases in Japan. Int Arch Occup Environ Health 2016; 89:1329-1335. [DOI: 10.1007/s00420-016-1168-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 09/05/2016] [Indexed: 11/24/2022]
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