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Much attention has been paid to the health effects of ambient particulate matter pollution; the effects of gaseous air pollutants have not been well studied. Emergency ambulance calls (EACs) may provide a better indicator of the acute health effects than the widely used health indicators, such as mortality and hospital admission. We estimated the short-term associations between gaseous air pollutants [nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 )] and EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and pooled associations. Stratified analyses were conducted by age, sex, and season. A total of 1,626,017 EACs were observed for all-cause EACs, including 230,537 from cardiovascular diseases, and 96,483 from respiratory diseases. Statistically significant associations were observed between NO 2 and EACs for all-cause diseases, while the effects of SO 2 were positive, but not statistically significant in most models. No significant relationship was found between O 3 and EACs. Specifically, each 10 μg/m 3 increase in the 2-day moving average concentration of NO 2 was associated with a 1.07% [95% confidence interval (CI): 0.40%, 1.76%], 0.76% (95% CI: 0.19%, 1.34%) and 0.06% (95% CI: -1.57%, 1.73%) increase in EACs due to all-cause, cardiovascular and respiratory diseases, respectively. Stratified analysis showed a larger effect of NO 2 on all-cause EACs in the cold season [excess relative risk (ERR): 0.33% (95% CI: 0.05%, 0.60%) for warm season, ERR: 0.77% (95% CI: 0.31%, 1.23%) for cold season]. Our study indicates that acute exposures to NO 2 might be an important trigger of the emergent occurrence of all-cause, cardiovascular and respiratory diseases, and this effect should be of particular concern in the cold season. Further policy development for controlling gaseous air pollution is warranted to reduce the emergent occurrence of cardiopulmonary diseases., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Compared with mortality and hospital admission, emergency ambulance calls (EACs) could be a more accurate outcome indicator to reflect the health effects of short-term air pollution exposure. However, such studies have been scarce, especially on a multicity scale in China., Methods: We estimated the associations of different diameter particles [i.e., inhalable particulate matter (PM 10 ), coarse particulate matter (PM c ), and fine particulate matter (PM 2.5 )] with EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities. We collected data on EACs and air pollution from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and overall associations. Stratified analyses were conducted to examine the effect modifications of gender, age, and season., Results: Significant associations of PM 10 and PM 2.5 with EACs were observed, while the PM c associations were positive but not statistically significant in most analyses. Specifically, each 10 μg/m 3 increase in 2-day moving average concentration of PM 10 was associated with a 0.25% [95% confidence interval (CI): 0.04%, 0.47%] increase in all-cause EACs, 0.13% (95% CI: -0.01%, 0.26%) in cardiovascular EACs, and 0.35% (95% CI: 0.04%, 0.66%) in respiratory EACs. The corresponding increases in daily EACs for PM 2.5 were 0.30% (95% CI, 0.03%, 0.57%), 0.13% (95% CI, -0.07%, 0.33%), and 0.46% (95% CI, 0.01%, 0.92%). Season of the year also modifies the association between particulate matter pollution and EACs., Conclusions: Short-term exposure to PM 10 and PM 2.5 were positively associated with daily all-cause and respiratory-related EACs. The associations were stronger during warm season than cold season. Our findings suggest that the most harmful fraction of particulate matter pollution is PM 2.5 , which has important implications for current air quality guidelines and regulations in China., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Most studies on the short-term health effects of air pollution have been conducted on a daily time scale, while hourly associations remain unclear., Methods: We collected the hourly data of emergency ambulance calls (EACs), ambient air pollution, and meteorological variables from 2014 to 2016 in Luoyang, a central Chinese city in Henan Province. We used a generalized additive model to estimate the hourly effects of ambient air pollutants (PM 2.5 , PM 10 , SO 2 , and NO 2 ) on EACs for all natural causes and cardiovascular and respiratory morbidity, with adjustment for potential confounding factors. We further examined the effect modification by temperature, relative humidity, wind speed, and atmospheric pressure using stratified analyses., Results: In the single-pollutant models, PM 2.5 , PM 10 , SO 2 , and NO 2 were associated with an immediate increase in all-cause morbidity at 0, 0, 12, 10 h, separately, after exposure to these pollutants (excess risks: 0.19% (95% confidence interval (CI): 0.03%, 0.35%), 0.13% (95% CI: 0.02%, 0.24%), 0.28% (95% CI: 0.01%, 0.54%) and 0.52% (95% CI: 0.06%, 0.99%), respectively). These effects remained generally stable in two-pollutant models. SO 2 and NO 2 were significantly associated with an immediate increase in risk of cardiovascular morbidity, but the effects on respiratory morbidity were relatively more delayed. The stratified analyses suggested that temperature could modify the association between PM 2.5 and EACs, humidity and atmospheric pressure could modify the association between SO 2 and EACs., Conclusions: Our study provides new evidence that higher concentrations of PM 2.5 , PM 10 , SO 2 , and NO 2 may have transiently acute effects on all-cause morbidity and subacute effects on respiratory morbidity. SO 2 and NO 2 may also have immediate effects on cardiovascular morbidity. Findings of this study have important implications for the formation of hourly air quality standards., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Different seasonal health effects of ambient ozone (O) have been reported in previous studies. This might be due to inappropriate adjustment of temperature in different seasons. We used daily data on non-accidental mortality and ambient air pollution in Zhengzhou from January 19, 2013 to June 30, 2015. Season-stratified analyses using generalized additive models were conducted to evaluate the seasonal associations with adjustment of temperature with different lagged days (lag0-1 for warm season, lag0-14 for cold season). We recorded a total of 70,443 non-accidental deaths in Zhengzhou during the study period. Significant associations were observed between ambient O and mortality in cold season. Every 10-μg/m increment of 24-h O of 1-day lagged time was associated with a 1.38% (95% CI 0.60, 2.16%) increase in all cause mortality, 1.35% (95% CI 0.41, 2.30%) increase in cardiovascular mortality, and 1.78% (95% CI 0.43, 3.14%) increase in respiratory mortality. Similar associations were observed when using daily 1- and 8-h maximum concentrations of O. No significant association was found during warm season. This study suggests a more pronounced ozone-mortality association in cold season in Zhengzhou, and we suggest that different lagged temperatures should be considered when examining the seasonal health effects of ambient ozone. [ABSTRACT FROM AUTHOR]