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Canadian ED visits track CO, NO2, ozone, and PM

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In seven Canadian cities, carbon monoxide and NO2 align with cardiac emergency visits, ozone with respiratory visits, and particles with warm-season asthma.

Source

Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis

Stieb DM, Szyszkowicz M, Rowe BH, et al. · Environmental health : a global access science source · 2009

doi.org/10.1186/1476-069x-8-25Read the full paper ↗175 citationscc by

Study at a glance

Design
Other — Multi-city daily time-series of ED visits vs gaseous and particulate pollutants
N
N=400000 · Nearly 400,000 ED visits to 14 hospitals in seven Canadian cities
Population
Cardiac and respiratory emergency department visits in seven Canadian cities
Outcome
ED visit associations with CO, NO2, O3, SO2, and PM by season and lag

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Authors pooled daily time-series of ED visits from 14 hospitals in seven cities, linking CO, NO2, O3, SO2, PM10, and PM2.5 at lags 0–2 days (and 3-hour averages) to cardiac and respiratory diagnoses after weather adjustment.

What they found

CO and NO2 showed the most consistent cardiac associations (e.g., warm-season CO: +5.2% MI/angina per 0.7 ppm). Ozone tracked asthma and COPD (COPD +6.2% per 18.4 ppb in the warm season). Warm-season PM10 and PM2.5 were strongly linked to asthma visits. Three-hour same-day averages showed no consistent signal.

The limits

What it doesn't show

Edmonton supplied ~70% of visits, children’s hospitals were missing in most cities, and the design cannot assign personal exposure or prove a single causal pollutant among correlated gases.

Key terms

Emergency department (ED) visit
A same-day hospital presentation, capturing a broader population than admissions alone.
NAPS
Canada’s National Air Pollution Surveillance network supplying hourly pollutant data.
Lag 0–2 days
Pollution on the visit day and the two preceding days.
Warm season
The part of the year when people spend more time outdoors and some pollutant–visit associations were larger.
Pooled multi-city estimate
A combined effect across cities that can be significant even when single-city estimates are noisy.

Flashcards

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Quiz yourself

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Cardiac ED visits associated most consistently with:

Common questions

Why study ED visits instead of deaths?

ED visits include many people who are never admitted (as few as 10% of asthma visits), so they reflect a broader population.

Which pollutants tracked the heart?

CO and NO2, especially myocardial infarction/angina and heart failure at lag 0.

Which tracked the lungs?

Ozone with asthma and COPD; PM10/PM2.5 with warm-season asthma.

Did sub-daily 3-hour peaks matter?

Not consistently, unlike daily averages lagged 0–2 days.

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