Background Globally nearly 20% of cardiovascular disease deaths were attributable to air pollution. Out-of-hospital cardiac arrest (OHCA) represents a major public health problem, therefore, the identification of novel OHCA triggers is of crucial relevance. The aim of the study was to evaluate the association between air pollution (short-, mid- and long-term exposure) and out-of-hospital cardiac arrest (OHCA) risk, during a 7 years-period from a highly polluted urban area in northern of Italy, with a high density of automated external defibrillators (AEDs). Methods OHCA were prospectively collected from the “Progetto Vita Database” between 01/01/2010 to 31/12/2017; day-by-day air pollution levels were extracted from the Environmental Protection Agency (ARPA) stations. Electrocardiograms of OHCA interventions were collected from the AEDs data cards. Day-by-day particulate matter (PM) 2.5 and 10, ozone (O3), carbon monoxide (CO) and nitrogen dioxide (NO2) levels were measured. Results A total of 880 OHCAs occurred in 748 days. A significantly increased in OHCA risk with the progressive increase in PM 2.5, PM 10, CO and NO2 levels was found. After adjustment for temperature and seasons, a 9% and 12% increase of OHCA risk for each 10 μg/m3 increase of PM 10 (p < 0.0001) and PM 2.5 (p < 0.0001) levels was found. Air pollutants levels were associated with both asystole and shockable rhythm risk while no correlation was found with pulseless electrical activity. Conclusions Short-term and mid-term exposure to PM 2.5 and PM 10 is independently associated with the risk of OHCA due to asystole or shockable rhythm.

中文翻译：

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空气污染和院外心脏骤停风险

背景 全球近 20% 的心血管疾病死亡归因于空气污染。院外心脏骤停 (OHCA) 是一个重大的公共卫生问题，因此，识别新的 OHCA 触发因素至关重要。该研究的目的是评估高度污染城市地区 7 年期间的空气污染（短期、中期和长期暴露）与院外心脏骤停 (OHCA) 风险之间的关联意大利北部拥有高密度的自动体外除颤器 (AED)。方法 OHCA 前瞻性地从“Progetto Vita 数据库”中收集 2010 年 1 月 1 日至 2017 年 12 月 31 日期间的 OHCA；从环境保护局 (ARPA) 站点提取每日空气污染水平。OHCA 干预的心电图是从 AED 数据卡中收集的。每天测量颗粒物 (PM) 2.5 和 10、臭氧 (O3)、一氧化碳 (CO) 和二氧化氮 (NO2) 水平。结果 748 天内总共发生 880 例 OHCA。研究发现，随着 PM 2.5、PM 10、CO 和 NO2 水平的逐渐增加，OHCA 风险显着增加。对温度和季节进行调整后，发现 PM 10 (p < 0.0001) 和 PM 2.5 (p < 0.0001) 水平每增加 10 μg/m3，OHCA 风险就会增加 9% 和 12%。空气污染物水平与心搏停止和可电击心律风险相关，但与无脉性电活动没有相关性。结论 短期和中期暴露于 PM 2.5 和 PM 10 与心搏停止或可电击节律引起的 OHCA 风险独立相关。