title: Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan.
abstract: Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in <3weeks hospitalization or no hospitalization) when compared to severe medical conditions (e.g. critical cases, and cases that led to >3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan. Electronic address: saira@health.env.kyoto-u.ac.jp.
authors.forename: Saira
authors.initials: S
authors.lastname: Tasmin
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Stockholm Center on Health and Social Change (Scohost), Södertörn University, 141 89 Huddinge, Sweden.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Kinugasa Research Organization, Ritsumeikan University, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yasumoto
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
authors.forename: Vera Ling Hui
authors.initials: VLH
authors.lastname: Phung
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Oishi
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
authors.forename: Shusuke
authors.initials: S
authors.lastname: Yasukouchi
authors.affiliation: Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
authors.forename: Yamato
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: Center for Environmental Health Sciences, National Institute for Environmental Studies (NIES), Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Michikawa
authors.affiliation: Center for Environmental Health Sciences, National Institute for Environmental Studies (NIES), Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nitta
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis; D000552:Ambulances / Q000706:statistics & numerical data*; D004781:Environmental Exposure; D006801:Humans; D007564:Japan; D052638:Particulate Matter / Q000032:analysis*; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Emergency ambulance dispatch (EAD); Japan; Short-term exposure; Suspended particulate matter (SPM)