title: Ambient particulate matter, landscape fire smoke, and emergency ambulance dispatches in Sydney, Australia.
abstract: Emergency ambulance dispatches (EAD) are a novel outcome for evaluating the public health impacts of air pollution. We assessed the relationships between ambient particulate matter (PM) from all sources, PM from landscape fire smoke (LFS), and EADs likely to be associated with cardiorespiratory problems in the Sydney greater metropolitan region for an 11-year period from 2004 to 2015.
  
  
  
  EAD codes are assigned at the time of the call to emergency services using standard computer assisted algorithms. We assessed EADs coded as: breathing problems, chest pain, stroke or cerebrovascular accident (stroke), cardiac or respiratory arrest and death (arrest), and heart or defibrillator problems (other heart problems). Using a daily times series study design with a generalized linear Poisson regression model we quantified the association between EAD and daily PM2.5from all sources (PM2.5,all) and PM2.5primarily due to LFS (PM2.5,LFS).
  
  
  
  Increases of 10μg·m-3in PM2.5,allwere positively associated with same day EAD for breathing problems (RR=1.03, 95% CI 1.02 to 1.04), arrest (RR=1.03, 95% CI 1.00 to 1.06), and chest pain (RR=1.01 CI 1.00 to 1.02) but not with other outcomes. Increases of 10μg·m-3PM2.5,LFSwere also positively associated with breathing problems on the same day (RR=1.04, 95% CI 1.02 to 1.05) and other heart problems at lag of two days (RR=1.05, 95% CI 1.01 to 1.09).
  
  
  
  Emergency dispatches for breathing problems are associated with PM2.5,alland PM2.5,LFSand provide a sensitive end point for continued research and surveillance activities investigating the impacts of daily fluctuations in ambient PM2.5.
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: Farhad
authors.initials: F
authors.lastname: Salimi
authors.affiliation: Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Henderson
authors.affiliation: University Centre for Rural Health - North Coast, School of Public Health, University of Sydney, Australia.
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Morgan
authors.affiliation: School of Public Health and Community Medicine and Ingham Institute of Applied Medical Research, University of New South Wales, Australia.
authors.forename: Bin
authors.initials: B
authors.lastname: Jalaludin
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. Electronic address: fay.johnston@utas.edu.au.
authors.forename: Fay H
authors.initials: FH
authors.lastname: Johnston
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D000552:Ambulances / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D004781:Environmental Exposure; D005390:Fires; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D052638:Particulate Matter / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000453:epidemiology*; D012906:Smoke / Q000009:adverse effects*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D012906:Smoke
keywords: Emergency ambulance dispatches; Landscape fire smoke; Particulate matter