Department of Emergency Medicine, Chest Pain Center, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
School of Public Health, Fudan University, Shanghai, China.
J Hazard Mater. 2023 Sep 5;457:131829. doi: 10.1016/j.jhazmat.2023.131829. Epub 2023 Jun 10.
Out-of-hospital cardiac arrest (OHCA) is a global public health concern. Nationwide studies on the effects of short-term exposure to particulate matter (PM) on OHCA risk are rare in regions with high PM levels, and evidence for coarse PM (PM) is limited and inconsistent. To evaluate the associations between fine PM (PM) and PM and OHCA onset, a time-stratified case-crossover study was conducted on 77,261 patients with cardiac OHCA in 26 cities across China in 2020. Daily PM and PM concentrations were assessed with high-resolution and full-coverage PM estimations. Conditional logistic regression models were applied in analyses. Each interquartile range of PM increase in 3-day moving average was associated with an increased risk of cardiac OHCA onset of 2.37% (95% CI, 1.20-3.56%) for PM and 2.12% (95% CI, 0.70-3.56%) for PM. Stratified analyses showed higher susceptibility in patients over 75 years for PM exposure and with diabetes for PM. This first nationwide study in region with high PM levels and great PM variability found not only PM but also PM were associated with a higher risk of OHCA onset, which could add powerful epidemiological evidence to this field and provide new evidence for the formulation of air quality guidelines.
院外心脏骤停 (OHCA) 是一个全球性的公共卫生关注点。在 PM 水平较高的地区，关于短期暴露于颗粒物 (PM) 对 OHCA 风险影响的全国性研究很少，而关于粗颗粒物 (PM) 的证据有限且不一致。为了评估细颗粒物 (PM) 和 PM 与 OHCA 发病之间的关联，在中国 26 个城市的 77261 例心脏 OHCA 患者中进行了一项时间分层病例交叉研究。采用高分辨率和全覆盖的 PM 估算方法评估每日 PM 和 PM 浓度。在分析中应用了条件逻辑回归模型。3 天移动平均的 PM 每增加一个四分位距，与 PM 导致的心脏 OHCA 发病风险增加 2.37%（95%CI，1.20-3.56%）和 PM 导致的发病风险增加 2.12%（95%CI，0.70-3.56%）相关。分层分析显示，PM 暴露的患者年龄超过 75 岁，以及患有糖尿病的患者对 PM 更为敏感。这项在 PM 水平较高且 PM 变化较大的地区进行的首次全国性研究发现，不仅 PM，而且 PM 都与 OHCA 发病风险的增加相关，这为该领域提供了有力的流行病学证据，并为空气质量标准的制定提供了新的证据。
