title: Acute effect of ambient air pollution on heart failure in Guangzhou, China.
abstract: BACKGROUND
  Heart failure (HF) is a global public health problem of increasing importance. The association between acute exposure to air pollution and HF has been well established in developed countries, but little evidence was available in developing countries where air pollution levels were much higher. We conducted a time-series study to investigate the short-term association between air pollution and overall emergency ambulance dispatches (EAD) due to HF in Guangzhou, China.
  
  
  METHODS
  Daily data of EAD due to HF from 1 January 2008 to 31 December 2012 were obtained from Guangzhou Emergency Center. We applied the over-dispersed Poisson generalized addictive model to analyze the associations after controlling for the seasonality, day of the week and weather conditions.
  
  
  RESULTS
  We identified a total of 3375 EAD for HF. A 10-μg/m(3) increase in the present-day concentrations of particulate matter with an aerodynamic diameter of less than 10 μm, sulfur dioxide and nitrogen dioxide corresponded to increases of 3.54% [95% confidence interval (CI): 1.35%, 5.74%], 5.29% (95% CI: 2.28%, 8.30%) and 4.34% (95% CI: 1.71%, 6.97%) in daily EAD for HF, respectively. The effects of air pollution on acute HF were restricted on the concurrent day and in the cool seasons.
  
  
  CONCLUSIONS
  Our results provided the first population-based evidence in Mainland China that outdoor air pollution could trigger the exacerbation of HF.
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China.
authors.forename: Changyuan
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Ailan
authors.initials: A
authors.lastname: Chen
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: Guangzhou First Aid Medical service Control Center, Guangzhou 510630, China.
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Guangzhou First Aid Medical service Control Center, Guangzhou 510630, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Ye
authors.affiliation: Guangzhou First Aid Medical service Control Center, Guangzhou 510630, China.
authors.forename: Shuangming
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Affiliated Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou 21018, China.
authors.forename: Wanglin
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Zijing
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liang
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Duanqiang
authors.initials: D
authors.lastname: Guo
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China. Electronic address: haidongkan@gmail.com.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510182, China; Guangzhou Hoffmann Institute of Immunology, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China; Department of Pathogenic Biology, Guangzhou Medical University, Guangzhou 510182, China. Electronic address: chenxinyu1357@163.com.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Chen
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D065186:Interrupted Time Series Analysis / Q000379:methods* / Q000639:trends; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D012621:Seasons; D013997:Time Factors
chemical_list: D052638:Particulate Matter
keywords: Air pollution; Emergency ambulance dispatches; Emergency medicine; Heart failure; Time-series study