title: Air pollution and activation of mobile medical team for out-of-hospital cardiac arrest.
abstract: BACKGROUND
  The association between air pollution exposure and cardiovascular events is well established, and the effect of short-term exposure on out-of-hospital cardiac arrest (OHCA) has received some attention. The effect of air pollution exposure and the activation of mobile intensive care units (MICUs) for cardiac arrest have never been studied.
  
  
  OBJECTIVE
  We analyzed associations between air pollutants and MICU activation for OHCA.
  
  
  METHODS
  This is a retrospective study including 4558 patients with OHCA and MICU activation from 2007 to 2012. A time-stratified case crossover design was used. Particulate matter (PM) of median aerodynamic diameter less than 2.5 μm (PM2.5), less than 10 μm, and ozone were the 3 main pollutants used to determine the effects of pollution exposure on the event.
  
  
  RESULTS
  A daily average increase of 27.6 μg/m(3) in ozone was associated with an increase of MICU activation for OHCA the following day (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.03-1.22). For women, a daily average increase of 27.6 μg/m(3) in ozone was associated with an increase of MICU activation for OHCA the following day (OR, 1.19; 95% CI, 1.01-1.37). An hourly average increase of 10.5 μg/m(3) in PM2.5 was associated with an increase of MICU activation for OHCA in the current hour (OR, 1.11; 95% CI, 1.02-1.19). For men, an increase in PM2.5 was associated with an increase in MICU activation for OHCA the current hour (OR, 1.10; 95% CI, 1.01-1.20). No association was found with PM of median aerodynamic diameter less than 10 μm.
  
  
  CONCLUSIONS
  An association was found between air pollution and MICU activation for OHCA (ozone and PM2.5).
authors.affiliation: SAMU-SMUR, Département des Urgences, Centre Hospitalier Universitaire Pellegrin, place Amélie Raba Léon, 33076 Bordeaux, France. Electronic address: catherine.pradeau@chu-bordeaux.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pradeau
authors.affiliation: INSERM U897-ISPED, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Rondeau
authors.affiliation: INSERM U897-ISPED, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Lévèque
authors.affiliation: Airacq, surveillance de la qualité de l'air en Aquitaine, 33692 Merignac Cedex, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Guernion
authors.affiliation: SAMU-SMUR, Département des Urgences, Centre Hospitalier Universitaire Pellegrin, place Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Tentillier
authors.affiliation: SAMU-SMUR, Département des Urgences, Centre Hospitalier Universitaire Pellegrin, place Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Thicoipé
authors.affiliation: INSERM U897-ISPED, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France; Service de médecine du travail et de pathologies professionnelles and Équipe Associée en Santé Travail, Essat (InVS/DST-LSTE-EA3672), Centre Hospitalier Universitaire Pellegrin, place Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Brochard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000706:statistics & numerical data*; D000552:Ambulances / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data*; D018592:Cross-Over Studies; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology*; D010126:Ozone; D052638:Particulate Matter; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D052638:Particulate Matter; D010126:Ozone