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Journal Article Ppublish 11 citations

PubMed: 38215924 DOI: 10.1016/j.envres.2024.118175

Long-term exposure to PM2.5 species and all-cause mortality among Medicare patients using mixtures analyses.

Environ Res 246:118175

Authors: Mahdieh Danesh Yazdi, Heresh Amini, Yaguang Wei, Edgar Castro, Liuhua Shi, Joel D Schwartz

Affiliations

  • Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA.
  • Department of Environmental Medicine and Public Health, Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine, New York, NY, USA.
  • Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA.
  • Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.

Abstract

BACKGROUND

The relationship between long-term exposure to PM and mortality is well-established; however, the role of individual species is less understood.

OBJECTIVES

In this study, we assess the overall effect of long-term exposure to PM as a mixture of species and identify the most harmful of those species while controlling for the others.

METHODS

We looked at changes in mortality among Medicare participants 65 years of age or older from 2000 to 2018 in response to changes in annual levels of 15 PM components, namely: organic carbon, elemental carbon, nickel, lead, zinc, sulfate, potassium, vanadium, nitrate, silicon, copper, iron, ammonium, calcium, and bromine. Data on exposure were derived from high-resolution, spatio-temporal models which were then aggregated to ZIP code. We used the rate of deaths in each ZIP code per year as the outcome of interest. Covariates included demographic, temperature, socioeconomic, and access-to-care variables. We used a mixtures approach, a weighted quantile sum, to analyze the joint effects of PM species on mortality. We further looked at the effects of the components when PM mass levels were at concentrations below 8 μg/m, and effect modification by sex, race, Medicaid status, and Census division.

RESULTS

We found that for each decile increase in the levels of the PM mixture, the rate of all-cause mortality increased by 1.4% (95% CI: 1.3%-1.4%), the rate of cardiovascular mortality increased by 2.1% (95% CI: 2.0%-2.2%), and the rate of respiratory mortality increased by 1.7% (95% CI: 1.5%-1.9%). These effects estimates remained significant and slightly higher when we restricted to lower concentrations. The highest weights for harmful effects were due to organic carbon, nickel, zinc, sulfate, and vanadium.

CONCLUSIONS

Long-term exposure to PM species, as a mixture, increased the risk of all-cause, cardiovascular, and respiratory mortality.

MeSH

Mortality, Environmental Health, Medicare

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