eCite Digital Repository

Short-term exposure to sulfur dioxide and nitrogen monoxide and risk of out-of-hospital cardiac arrest


Zhao, B and Johnston, FH and Salimi, F and Oshima, K and Kurabayashi, M and Negishi, K, Short-term exposure to sulfur dioxide and nitrogen monoxide and risk of out-of-hospital cardiac arrest, Heart, Lung and Circulation pp. 1-8. ISSN 1443-9506 (2022) [Refereed Article]

Copyright Statement

Copyright (2022) Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.hlc.2022.08.010


Background and aims:Over the past decades, particulate matter (PM), especially fine PM <2.5 μm in aerodynamic diameter (PM2.5) has been a major research focus. However, the air pollutant is a mixture of gases or vapour-phase compounds, such as carbon monoxide (C), nitrogen oxides (NOx), photochemical oxidants (Ox), and sulfur dioxide (SO2). Little is known about their cardiovascular effect, individually or in combination with PM. Thus, we aimed to determine the associations between the incidence of acute cardiac events and both gaseous and PM using a case-crossover design.

Methods:Cardiovascular cases were identified through the Gunma Prefectural Ambulance Activity Database in Japan in 2015 (1,512 out-of-hospital cardiac arrest [OHCA] and 1,002 heart failures from 53,006 ambulance cases). Air quality data from the nearest station was for day of the arrest (lag0) and 1-2 days before the arrest (lag1, lag2) and the moving average across days 0-1 (lag0-1). Conditional logistic regression was used for unadjusted and adjusted analysis for temperature and humidity.

Results:Independent associations of OHCA were daily concentrations of SO2 at lag1 (OR 1.173, 95%CI 1.004, 1.370; p=0.044) and lag0-1 (OR 1.203, 95%CI 1.015, 1.425; p=0.033); and daily NO concentrations at lag2 (OR 1.039, 95%CI 1.007, 1.072; p=0.016). The incidence of heart failure was significantly associated with daily concentrations of Ox on the day of the event in univariable model but not after adjustment for temperature and humidity. No associations were found for other pollutants.

Conclusions:Short-term exposure to SO2 and NO are associated with an increased risk of OHCA.

Item Details

Item Type:Refereed Article
Keywords:air pollution, heart failure, out-of-hospital cardiac arrest, particulate matter, sulfur dioxide
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Environmental epidemiology
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Zhao, B (Miss Bing Zhao)
UTAS Author:Johnston, FH (Professor Fay Johnston)
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
ID Code:154484
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-12-03
Last Modified:2023-01-17

Repository Staff Only: item control page