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Journal Article Ppublish 4 citations

PubMed: 39575927 DOI: 10.1097/EDE.0000000000001820

Low-level PM 2.5 Exposure, Cardiovascular and Nonaccidental Mortality, and Related Health Disparities in 12 US States.

Epidemiology 36(2):253-263

Authors: Adjani A Peralta, Edgar Castro, Mahdieh Danesh Yazdi, Anna Kosheleva, Yaguang Wei, Joel Schwartz

Affiliations

  • From the Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
  • Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY.
  • Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.

Abstract

BACKGROUND

Investigations into long-term fine particulate matter (PM 2.5 ) exposure's impact on nonaccidental and cardiovascular (CVD) deaths primarily involve nonrepresentative adult populations at concentrations above the new Environmental Protection Agency annual PM 2.5 standard.

METHODS

Using generalized linear models, we studied PM 2.5 exposure on rates of five mortality outcomes (all nonaccidental, CVD, myocardial infarction, stroke, and congestive heart failure) in 12 US states from 2000 to 2016. We aggregated predicted annual PM 2.5 exposures from a validated ensemble exposure model, ambient temperature from Daymet predictions, and mortality rates to all census tract-years within the states. We obtained covariates from the decennial Census and the American Community Surveys and assessed effect measure modification by race and education with stratification.

RESULTS

For each 1-µg/m 3 increase in annual PM 2.5 , we found positive associations with all five mortality outcomes: all nonaccidental (1.08%; 95% confidence interval [CI]: 0.96%, 1.20%), all CVD (1.27%; 95% CI: 1.14%, 1.41%), myocardial infarction (1.89%; 95% CI: 1.67%, 2.11%), stroke (1.08%; 95% CI: 0.87%, 1.30%), and congestive heart failure (2.20%; 95% CI: 1.97%, 2.44%). Positive associations persisted at <8 µg/m 3 PM 2.5 levels and among populations with only under 65. In our study, race, but not education, modifies associations. High-educated Black had a 2.90% larger increased risk of CVD mortality (95% CI: 2.42%, 3.39%) compared with low-educated non-Black.

CONCLUSION

Long-term PM 2.5 exposure is associated with nonaccidental and CVD mortality in 12 states, below the new Environmental Protection Agency standard, for both low PM 2.5 regions and the general population. Vulnerability to CVD mortality persists among Black individuals regardless of education level.

MeSH

Mortality, Epidemiology, Stroke, Education

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