Work

Short‐Term Effect of Air Pollution on Out of Hospital Cardiac Arrest (OHCA) in Lombardy—A Case‐Crossover Spatiotemporal Study

Year: 2025

Type: article

Abstract: Evidence linking short‐term exposure to air pollution, particularly PM 2.5 , PM 10 , NO 2 , O 3 , SO 2 , and CO, with out‐of‐hospital cardiac arrest (OHCA) risk remains inconsistent. Large‐scale studies using advanced air pollution exposure assessment techniques and spatiotemporal modeling are limited. This study investigates the association between short‐term air pollution concentration, derived from satellite data, and OHCA events (2016 ‐ 2019) in Lombardy, Italy, using a time‐stratified case‐crossover design. A two‐stage distributed lag non‐linear model, adjusted for meteorological factors, long‐term trends, seasonality, intraweek patterns and holidays, is applied across 96 districts to estimate the exposure‐lag‐response relationship, followed by a regional meta‐analysis. Subgroup analyses by age and sex of OHCA patients, with models stratified by urban‐rural areas and seasons, and interaction with co‐pollutants, are conducted. Among 37,613 OHCA cases, significant associations between OHCA and air pollutants are observed: NO 2 shows a delayed effect at lag 4 per 10 µg m − 3 increase (RR: 1.071; 95%CI: 1.029–1.114), while PM 2.5 (RR: 1.029; 95%CI: 1.006–1.053), PM 10 (RR: 1.025; 95%CI: 1.005–1.046), and O 3 (RR: 1.009; 95%CI: 1.001–1.016) have immediate effects at lag 0 or lag 1. CO exhibits a modest association per 100 µg m − 3 increase (RR: 1.007; 95%CI: 1.000–1.013, lag 4). Risks are elevated in summer months, and varied by urban‐rural setting. No significant effect modification is detected across age or sex subgroups. Bi‐pollutant models reveal notable interaction and confounding patterns.

Source: Global Challenges

DOI: 10.1002/gch2.202500241

Authors: Amruta Umakant Mahakalkar, Enrico G. Caiani, Giuseppe Stirparo, Elena Ticozzi, Lorenzo Gianquintieri

Institutions: Politecnico di Milano, IRCCS Istituto Auxologico Italiano, Agenzia Regionale Emergenza Urgenza

Language: English

Topic: Air Quality and Health Impacts

Subfield: Health, Toxicology and Mutagenesis

Field: Environmental Science

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,810