Ambulance Services Associated with Extreme Temperatures and Fine Particles in a Subtropical Island

• Published in: Scientific reports Vol. 10; no. 1; p. 2855
• Main Authors: Wang, Yu-Chun, Lin, Yu-Kai, Chen, Yi-Jhih, Hung, Shih-Chan, Zafirah, Yasmin, Sung, Fung-Chang
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 18.02.2020; Nature Publishing Group
• Subjects: 692/499; 692/700/478; Air Pollutants - adverse effects; Air Pollution - adverse effects; Ambient temperature; Ambulance services; Ambulances; Chest; Coma; Extreme Weather; Fainting; Female; Headache; Hot Temperature; Humanities and Social Sciences; Humans; Islands; Low temperature; Male; Middle Aged; multidisciplinary; Out-of-Hospital Cardiac Arrest - epidemiology; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - prevention & control; Pain; Particulate matter; Particulate Matter - adverse effects; Risk; Risk Factors; Science; Science (multidisciplinary); Syncope; Taiwan - epidemiology; Temperature; Temperature requirements; Tropical Climate - adverse effects; Vertigo; Taiwan
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-59294-8

This study evaluated the association between the risk of events requiring ambulance services and the ambient temperature and particulate matter of 2.5 μm (PM 2.5 ) and 10 μm (PM 10 ) for populations living in subtropical Taiwan. We used a distributed lag nonlinear model with a quasi-Poisson function to assess the roles of ambient temperature, PM 10 and PM 2.5 in the use of ambulance services for respiratory distress, coma and unconsciousness, chest pain, lying down in public, headaches/dizziness/vertigo/fainting/syncope and out-of-hospital cardiac arrest (OHCA). The relative risk (RR) and 95% confidence interval (CI) of each specific event were calculated in association with the ambient conditions. In general, the events that required ambulance services had a V-shaped or J-shaped association with the temperature, where the risks were higher at extreme temperatures. The RR of each event was significant when the patients were exposed to temperatures in the 5 th percentile (<15 °C); patients with OHCA had the highest adjusted RR of 1.61 (95% CI = 1.47–1.77). The risks were also significant for coma/unconsciousness, headaches/dizziness/vertigo/fainting/syncope, and OHCA but not for respiratory distress, chest pain and lying down in public, after exposure to the 99 th percentile temperatures of >30 °C. The risks for use of ambulance services increased with PM exposure and were significant for events of respiratory distress, chest pain and OHCA after exposure to the 99 th percentile PM 2.5 after controlling for temperatures. Events requiring ambulance services were more likely to occur when the ambient temperature was low than when it was high for the population on the subtropical island of Taiwan. The association of the risk of events requiring ambulance services with PM were not as strong as the association with low temperatures.