Association between EMS calls and fine particulate air pollution in Utah

Abstract

Multiple studies have noted an association between ambient air pollution and cardiovascular and pulmonary disease. Our goal was to investigate the potential relationship between fine particulate air pollution and emergency medical services (EMS) calls with a particular focus on cardiovascular and respiratory complaints. Utilizing a database of 911 emergency calls from the National EMS Information System, we analyzed 322,097 eligible EMS encounters in Utah over a 4-year period. We evaluated the relationship between the health emergency, as noted by the EMS provider’s primary impression, and short-term exposure to fine particulate matter (aerodynamic diameter ≤2.5-μm cut point (PM2.5)), as recorded by the United States Environmental Protection Agency (EPA) Air Quality System (AQS). Using a case crossover design and conditional logistic regression, we analyzed the association between health emergencies and PM2.5 concentrations over varying time exposures. At the 95 % confidence level, we found significant associations only between pollution exposure and EMS calls for diabetic symptoms (using pollution from the concurrent day) and syncope/fainting (using pollution from the concurrent day and from 2- to 5-day lagged moving averages). We found no other significant positive associations between health emergencies and PM2.5 concentration. In particular, we noted no association between daily PM2.5 concentration and EMS calls for cardiac arrest, chest pain, or respiratory distress. We found limited association between ambient air pollution and health emergencies, as classified by the EMS provider’s impression. We noted no association with primary cardiovascular or respiratory complaints.