Straney Lahn, Finn Judith, Dennekamp Martine, Bremner Alexandra, Tonkin Andrew, Jacobs Ian
School of Public Health and Preventive Medicine, Monash University, , Melbourne, Victoria, Australia.
J Epidemiol Community Health. 2014 Jan;68(1):6-12. doi: 10.1136/jech-2013-202955. Epub 2013 Sep 17.
Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Several studies have found that an increased level of ambient particulate matter (PM) smaller than 2.5 microns (PM2.5) is associated with an increased risk of OHCA. We investigated the relationship between air pollution levels and the incidence of OHCA in Perth, Western Australia.
We linked St John Ambulance OHCA data of presumed cardiac aetiology with Perth air pollution data from seven monitors which recorded hourly levels of PM smaller than 2.5 and 10 microns (PM2.5/PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3). We used a case-crossover design to estimate the strength of association between ambient air pollution levels and risk of OHCA.
Between 2000 and 2010, there were 8551 OHCAs that met the inclusion criteria. Of these, 5624 (65.8%) occurred in men. An IQR increase in the 24 and 48 h averages of PM2.5 was associated with 10.6% (OR 1.106, 95% CI 1.038 to 1.180) and 13.6% (OR 1.136, 95% CI 1.051 to 1.228) increases, respectively, in the risk of OHCA. CO showed a consistent association with increased risk of an OHCA. An IQR increase in the 4 h average concentration of CO was associated with a 2.2% (OR 1.022, 95% CI 1.002 to 1.042) increase in risk of an OHCA. When we restricted our analysis of CO to arrests occurring between 6:00 and 10:00, we found a 4.4% (95% CI 1.1% to 7.8%) increase in risk of an OHCA.
Elevated ambient PM2.5 and CO are associated with an increased risk of OHCA.
院外心脏骤停（OHCA）仍然是一个重大的公共卫生问题。多项研究发现，环境中小于2.5微米的颗粒物（PM2.5）水平升高与OHCA风险增加有关。我们调查了西澳大利亚州珀斯市空气污染水平与OHCA发病率之间的关系。
我们将圣约翰救护车记录的推测为心脏病因的OHCA数据与来自七个监测器的珀斯空气污染数据相联系，这些监测器每小时记录小于2.5微米和10微米的颗粒物（PM2.5/PM10）、一氧化碳（CO）、二氧化硫（SO2）、二氧化氮（NO2）和臭氧（O3）的水平。我们采用病例交叉设计来估计环境空气污染水平与OHCA风险之间的关联强度。
2000年至2010年期间，有8551例OHCA符合纳入标准。其中，5624例（65.8%）发生在男性中。PM2.5的24小时和48小时平均水平每增加一个四分位间距，OHCA风险分别增加10.6%（比值比1.106，95%置信区间1.038至1.180）和13.6%（比值比1.136，95%置信区间1.051至1.228）。CO与OHCA风险增加呈现出一致的关联。CO的4小时平均浓度每增加一个四分位间距，OHCA风险增加2.2%（比值比1.022，95%置信区间1.002至1.042）。当我们将对CO的分析限制在6:00至10:00之间发生的心脏骤停时，我们发现OHCA风险增加了4.4%（95%置信区间1.1%至7.8%）。
环境中PM2.5和CO水平升高与OHCA风险增加有关。
