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. 2018 Feb 9;15(2):307.
doi: 10.3390/ijerph15020307.

Acute Effects of Ambient PM2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan

Vera Ling Hui Phung  1 , Kayo Ueda  2 , Shunji Kasaoka  3 , Xerxes Seposo  4 , Saira Tasmin  5 , Shinichi Yonemochi  6 , Arthit Phosri  7 , Akiko Honda  8 , Hirohisa Takano  9 , Takehiro Michikawa  10 , Hiroshi Nitta  11
Affiliations

Acute Effects of Ambient PM2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan

Vera Ling Hui Phung et al. Int J Environ Res Public Health. .

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.

Keywords: air pollution; ambient PM2.5; emergency ambulance dispatches; short-term exposure.

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Conflict of interest statement

The authors declare no conflict of interest. The funding sponsors had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, nor in the decision to publish the results.

Figures

Figure 1
Figure 1
Map of Japan showing the eight cities included in this study.
Figure 2
Figure 2
City-specific percent change of all-cause EAD associated with a 10 µg/m3 increase in PM2.5 in the unconstrained, distributed lag model.
Figure 3
Figure 3
Percent change of all-cause EAD (pooled effect) associated with a 10 µg/m3 increase in PM2.5 in the (a) unconstrained, distributed lag, and (b) average lag models.
Figure 4
Figure 4
Percent change of all-cause EAD at lag 0 when adjusted using two-pollutant models. Each pollutant was included in the model one at a time.
See this image and copyright information in PMC

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