TY - JOUR
T1 - Ambient air pollution and out-of-hospital cardiac arrest. Israel nation wide assessment
AU - Kranc, Hannan
AU - Novack, Victor
AU - Shtein, Alexandra
AU - Sonkin, Roman
AU - Jaffe, Eli
AU - Novack, Lena
N1 - Funding Information:
We are grateful to Simcha Levental, a Geospatial Analyst, and Amos Porat, the head of climate department, Israeli meteorological service, who assisted us in calculations related to geographical and meteorological exposures used in the study. We appreciate the support of the Negev Environmental Health Research Institute in Soroka University Medical Center and the Environmental Epidemiology Research Center in Ben-Gurion University.
Publisher Copyright:
© 2021 The Authors
PY - 2021/9/15
Y1 - 2021/9/15
N2 - Introduction: Previous research suggested that an out-of-hospital cardiac arrest (OHCA) may be triggered by an exposure to ambient pollutants. Objective: We investigated the link between OHCA and a short-term exposure to particulate matter (PM) and other pollutants, within extreme climate conditions in Israel and high PM. Methods: In a case-crossover analysis, we analyzed all adult cases of OHCA in Israel during 2016–2017. The air-pollution and meteorology data were retrieved from the 132 monitoring stations. All associations at study were investigated using a lag-distributed regression and adjusted to temperature and humidity. Results: There were 12401 OHCA cases. Patients experiencing OHCA were likely to be exposed to elevated levels of pollutants, specifically, nitrogen dioxide (NO2) and particulate matter of size ≤2.5 μm (PM2.5) several hours prior to an event, although both at borderline significance, i.e. odds ratio (OR) = 1.20 (95%CI 0.96; 1.51) and OR = 1.15 (95%CI 0.84; 1.60), respectively. An exposure to NO2 was independently associated with OHCA among males (OR = 1.39, 95%CI 0.96; 2.01) and if occurred during the midweek (OR = 1.43, 95%CI 1.03; 1.97). The adverse effect of PM10 was more evident during a weekend (OR = 2.36, 95%CI 0.88; 6.28), as opposed to working days (OR = 0.81, 95%CI 0.45; 1.44). Analysis stratified by regions suggested a spatial variability in pollution associated with OHCA. Conclusions: Short-term exposure to high levels of pollution is adversely associated with OHCA independently of meteorological conditions. The magnitude of the effect is modified by patients' demography. Main finding: Short-term exposure to high levels of pollution is adversely associated with OHCA. This effect is independent of temperature and humidity.
AB - Introduction: Previous research suggested that an out-of-hospital cardiac arrest (OHCA) may be triggered by an exposure to ambient pollutants. Objective: We investigated the link between OHCA and a short-term exposure to particulate matter (PM) and other pollutants, within extreme climate conditions in Israel and high PM. Methods: In a case-crossover analysis, we analyzed all adult cases of OHCA in Israel during 2016–2017. The air-pollution and meteorology data were retrieved from the 132 monitoring stations. All associations at study were investigated using a lag-distributed regression and adjusted to temperature and humidity. Results: There were 12401 OHCA cases. Patients experiencing OHCA were likely to be exposed to elevated levels of pollutants, specifically, nitrogen dioxide (NO2) and particulate matter of size ≤2.5 μm (PM2.5) several hours prior to an event, although both at borderline significance, i.e. odds ratio (OR) = 1.20 (95%CI 0.96; 1.51) and OR = 1.15 (95%CI 0.84; 1.60), respectively. An exposure to NO2 was independently associated with OHCA among males (OR = 1.39, 95%CI 0.96; 2.01) and if occurred during the midweek (OR = 1.43, 95%CI 1.03; 1.97). The adverse effect of PM10 was more evident during a weekend (OR = 2.36, 95%CI 0.88; 6.28), as opposed to working days (OR = 0.81, 95%CI 0.45; 1.44). Analysis stratified by regions suggested a spatial variability in pollution associated with OHCA. Conclusions: Short-term exposure to high levels of pollution is adversely associated with OHCA independently of meteorological conditions. The magnitude of the effect is modified by patients' demography. Main finding: Short-term exposure to high levels of pollution is adversely associated with OHCA. This effect is independent of temperature and humidity.
KW - Air pollution
KW - NO
KW - OHCA
KW - PM
KW - SO
UR - http://www.scopus.com/inward/record.url?scp=85109440752&partnerID=8YFLogxK
U2 - 10.1016/j.atmosenv.2021.118567
DO - 10.1016/j.atmosenv.2021.118567
M3 - Article
AN - SCOPUS:85109440752
SN - 1352-2310
VL - 261
JO - Atmospheric Environment
JF - Atmospheric Environment
M1 - 118567
ER -