title: Asian dust and daily emergency ambulance calls among elderly people in Japan: an analysis of its double role as a direct cause and as an effect modifier.
abstract: OBJECTIVE
  To evaluate the direct health effects of Asian dust on ambulance calls and its role as an effect modifier on the effects of anthropogenic air pollution in Japan.
  
  
  METHODS
  The subjects were 51,945 elderly residents who visited hospital emergency departments from 2006 to 2010. We evaluated the impact of Asian dust by time-series analyses and the excess risk from suspended particulate matter (SPM) stratified by Asian-dust exposure.
  
  
  RESULTS
  Asian dust was associated with daily ambulance calls due to all-cause, cardiovascular, and respiratory disease independently of SPM, for example, the relative risk per interquartile increase in Asian dust (3-day lag) was 1.021 (1.002 to 1.039) for cardiovascular disease. Furthermore, Asian dust modified the effects of SPM on cardiovascular and respiratory diseases.
  
  
  CONCLUSIONS
  Asian dust had adverse effects and modified the effect of SPM.
authors.affiliation: From the Department of Public Health and Health Policy (Dr Kashima), Institute of Biomedical & Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima; Department of Human Ecology (Dr Yorifuji), Graduate School of Environmental and Life Science; and Department of Epidemiology (Dr Suzuki), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Kashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Yorifuji
authors.forename: Etsuji
authors.initials: E
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000552:Ambulances / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004391:Dust / Q000032:analysis; D015987:Effect Modifier, Epidemiologic; D004630:Emergencies; D004784:Environmental Monitoring; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D019037:Urban Health Services / Q000706:statistics & numerical data*
chemical_list: D000393:Air Pollutants; D004391:Dust; D052638:Particulate Matter