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Intensive care admissions and outcomes associated with short-term exposure to ambient air pollution: a time series analysis.

Groves, CP; Butland, BK; Atkinson, RW; Delaney, AP; Pilcher, DV (2020) Intensive care admissions and outcomes associated with short-term exposure to ambient air pollution: a time series analysis. Intensive Care Med, 46 (6). pp. 1213-1221. ISSN 1432-1238 https://doi.org/10.1007/s00134-020-06052-z
SGUL Authors: Atkinson, Richard William Butland, Barbara Karen

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Abstract

PURPOSE: Short-term exposure to outdoor air pollution has been positively associated with numerous measures of acute morbidity and mortality, most consistently as excess cardiorespiratory disease associated with fine particulate matter (PM2.5), particularly in vulnerable populations. It is unknown if the critically ill, a vulnerable population with high levels of cardiorespiratory disease, is affected by air pollution. METHODS: We performed a time series analysis of emergency cardiorespiratory, stroke and sepsis intensive care (ICU) admissions for the years 2008-2016, using data from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS-APD). Case-crossover analysis was conducted to assess the relationship between air pollution and the frequency and severity of ICU admissions having adjusted for temperature, humidity, public holidays and influenza activity. RESULTS: 46,965 episodes in 87 separate ICUs were analysed. We found no statistically significant associations with admission counts. However, ICU admissions ending in death within 30 days were significantly positively associated with short-term exposure to PM2.5 [RR 1.18, 95% confidence interval (CI) 1.02-1.37, per 10 µg/m3 increase]. This association was more pronounced in those aged 65 and over (RR 1.33, 95% CI 1.11-1.58, per 10 µg/m3). CONCLUSIONS: Increased ICU mortality was associated with higher levels of PM2.5. Larger studies are required to determine if the frequency of ICU admissions is positively associated with short-term exposure to air pollution.

Item Type: Article
Additional Information: This is a post-peer-review, pre-copyedit version of an article published in Intensive Care Medicine. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00134-020-06052-z
Keywords: Air pollution, Critical care, Intensive care (ICU), Particulate matter (PM2.5), 1103 Clinical Sciences, 1117 Public Health and Health Services, Emergency & Critical Care Medicine
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Intensive Care Med
ISSN: 1432-1238
Language: eng
Dates:
DateEvent
June 2020Published
30 April 2020Published Online
10 April 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 32355989
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111922
Publisher's version: https://doi.org/10.1007/s00134-020-06052-z

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