The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study
Background: Ambulance emergency calls (AECs) are seen as a more suitable metric for syndromic surveillance due to their heightened sensitivity in reflecting the health impacts of air pollutants. Limited evidence has emphasized the combined effect of hourly air pollutants on AECs. This study aims to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Toxics |
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| Online Access: | https://www.mdpi.com/2305-6304/11/11/895 |
| _version_ | 1797457601228701696 |
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| author | Hanxu Shi Qiang Zhou Hongjuan Zhang Shengzhi Sun Junfeng Zhao Yasha Wang Jie Huang Yinzi Jin Zhijie Zheng Rengyu Wu Zhenyu Zhang |
| author_facet | Hanxu Shi Qiang Zhou Hongjuan Zhang Shengzhi Sun Junfeng Zhao Yasha Wang Jie Huang Yinzi Jin Zhijie Zheng Rengyu Wu Zhenyu Zhang |
| author_sort | Hanxu Shi |
| collection | DOAJ |
| description | Background: Ambulance emergency calls (AECs) are seen as a more suitable metric for syndromic surveillance due to their heightened sensitivity in reflecting the health impacts of air pollutants. Limited evidence has emphasized the combined effect of hourly air pollutants on AECs. This study aims to investigate the combined effects of multipollutants (i.e., PM<sub>2.5</sub>, PM<sub>10</sub>, Ozone, NO<sub>2</sub>, and SO<sub>2</sub>) on all-cause and cause-specific AECs by using the quantile g-computation method. Methods: We used ambulance emergency dispatch data, air pollutant data, and meteorological data from between 1 January 2013 and 31 December 2019 in Shenzhen, China, to estimate the associations of hourly multipollutants with AECs. We followed a two-stage analytic protocol, including the distributed lag nonlinear model, to examine the predominant lag for each air pollutant, as well as the quantile g-computation model to determine the associations of air pollutant mixtures with all-cause and cause-specific AECs. Results: A total of 3,022,164 patients were identified during the study period in Shenzhen. We found that each interquartile range increment in the concentrations of PM<sub>2.5</sub>, PM<sub>10</sub>, Ozone, NO<sub>2</sub>, and SO<sub>2</sub> in 0–8 h, 0–8 h, 0–48 h, 0–28 h, and 0–24 h was associated with the highest risk of AECs. Each interquartile range increase in the mixture of air pollutants was significantly associated with a 1.67% (95% CI, 0.12–3.12%) increase in the risk of all-cause AECs, a 1.81% (95% CI, 0.25–3.39%) increase in the risk of vascular AECs, a 1.77% (95% CI, 0.44–3.11%) increase in reproductive AECs, and a 2.12% (95% CI, 0.56–3.71%) increase in AECs due to injuries. Conclusions: We found combined effects of pollutant mixtures associated with an increased risk of AECs across various causes. These findings highlight the importance of targeted policies and interventions to reduce air pollution, particularly for PM, Ozone, and NO<sub>2</sub> emissions. |
| first_indexed | 2024-03-09T16:24:22Z |
| format | Article |
| id | doaj.art-30993789775d4265910cf06dc4744bf7 |
| institution | Directory Open Access Journal |
| issn | 2305-6304 |
| language | English |
| last_indexed | 2024-03-09T16:24:22Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxics |
| spelling | doaj.art-30993789775d4265910cf06dc4744bf72023-11-24T15:09:17ZengMDPI AGToxics2305-63042023-10-01111189510.3390/toxics11110895The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series StudyHanxu Shi0Qiang Zhou1Hongjuan Zhang2Shengzhi Sun3Junfeng Zhao4Yasha Wang5Jie Huang6Yinzi Jin7Zhijie Zheng8Rengyu Wu9Zhenyu Zhang10Department of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaShenzhen Center for Prehospital Care, Shenzhen 518025, ChinaShenzhen Center for Prehospital Care, Shenzhen 518025, ChinaSchool of Public Health, Capital Medical University, Beijing 100054, ChinaSchool of Computer Science, Peking University, Beijing 100871, ChinaNational Engineering Research Center of Software Engineering, Peking University, Beijing 100871, ChinaSchool of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaShenzhen Center for Prehospital Care, Shenzhen 518025, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaBackground: Ambulance emergency calls (AECs) are seen as a more suitable metric for syndromic surveillance due to their heightened sensitivity in reflecting the health impacts of air pollutants. Limited evidence has emphasized the combined effect of hourly air pollutants on AECs. This study aims to investigate the combined effects of multipollutants (i.e., PM<sub>2.5</sub>, PM<sub>10</sub>, Ozone, NO<sub>2</sub>, and SO<sub>2</sub>) on all-cause and cause-specific AECs by using the quantile g-computation method. Methods: We used ambulance emergency dispatch data, air pollutant data, and meteorological data from between 1 January 2013 and 31 December 2019 in Shenzhen, China, to estimate the associations of hourly multipollutants with AECs. We followed a two-stage analytic protocol, including the distributed lag nonlinear model, to examine the predominant lag for each air pollutant, as well as the quantile g-computation model to determine the associations of air pollutant mixtures with all-cause and cause-specific AECs. Results: A total of 3,022,164 patients were identified during the study period in Shenzhen. We found that each interquartile range increment in the concentrations of PM<sub>2.5</sub>, PM<sub>10</sub>, Ozone, NO<sub>2</sub>, and SO<sub>2</sub> in 0–8 h, 0–8 h, 0–48 h, 0–28 h, and 0–24 h was associated with the highest risk of AECs. Each interquartile range increase in the mixture of air pollutants was significantly associated with a 1.67% (95% CI, 0.12–3.12%) increase in the risk of all-cause AECs, a 1.81% (95% CI, 0.25–3.39%) increase in the risk of vascular AECs, a 1.77% (95% CI, 0.44–3.11%) increase in reproductive AECs, and a 2.12% (95% CI, 0.56–3.71%) increase in AECs due to injuries. Conclusions: We found combined effects of pollutant mixtures associated with an increased risk of AECs across various causes. These findings highlight the importance of targeted policies and interventions to reduce air pollution, particularly for PM, Ozone, and NO<sub>2</sub> emissions.https://www.mdpi.com/2305-6304/11/11/895multipollutantambulance emergency calls (AECs)environmental epidemiology |
| spellingShingle | Hanxu Shi Qiang Zhou Hongjuan Zhang Shengzhi Sun Junfeng Zhao Yasha Wang Jie Huang Yinzi Jin Zhijie Zheng Rengyu Wu Zhenyu Zhang The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study Toxics multipollutant ambulance emergency calls (AECs) environmental epidemiology |
| title | The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study |
| title_full | The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study |
| title_fullStr | The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study |
| title_full_unstemmed | The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study |
| title_short | The Combined Effects of Hourly Multi-Pollutant on the Risk of Ambulance Emergency Calls: A Seven-Year Time Series Study |
| title_sort | combined effects of hourly multi pollutant on the risk of ambulance emergency calls a seven year time series study |
| topic | multipollutant ambulance emergency calls (AECs) environmental epidemiology |
| url | https://www.mdpi.com/2305-6304/11/11/895 |
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