Dataset Information

Fine particulate matters: The impact of air quality standards on cardiovascular mortality.

ABSTRACT:

Background

In 1997 the U.S. Environmental Protection Agency set the first annual National Ambient Air Quality Standard (NAAQS) for fine particulate matter (PM_2.5). Although the weight of scientific evidence has determined that a causal relationship exists between PM_2.5 exposures and cardiovascular effects, few studies have concluded whether NAAQS-related reductions in PM_2.5 led to improvements in public health.

Methods

We examined the change in cardiovascular (CV) mortality rate and the association between change in PM_2.5 and change in CV-mortality rate before (2000-2004) and after implementation of the 1997 annual PM_2.5 NAAQS (2005-2010) among U.S. counties. We further examined how the association varied with respect to two factors related to NAAQS compliance: attainment status and design values (DV). We used difference-in-differences and linear regression models, adjusted for sociodemographic confounders.

Findings

Across 619 counties, there were 1.10 (95% CI: 0.37, 1.82) fewer CV-deaths per year per 100,000 people for each 1µg/m³ decrease in PM_2.5. Nonattainment counties had a twofold larger reduction in mean annual PM_2.5, 2.1µg/m³, compared to attainment counties, 0.97µg/m³. CV-mortality rate decreased by 0.59 (95% CI: -0.54, 1.71) in nonattainment and 1.96 (95% CI: 0.77, 3.15) deaths per 100,000 people for each 1µg/m³ decrease in PM_2.5 in attainment counties. When stratifying counties by DV, results were similar: counties with DV greater than 15µg/m³ experienced the greatest decrease in mean annual PM_2.5 (2.29µg/m³) but the smallest decrease in CV-mortality rate per unit decrease in PM_2.5, 0.73 (95% CI: -0.57, 2.02).

Interpretation

We report a significant association between the change in PM_2.5 and the change in CV-mortality rate before and after the implementation of NAAQS and note that the health benefits per 1µg/m³ decrease in PM_2.5 persist at levels below the current national standard.

Funding

US EPA intermural research.

SUBMITTER: Corrigan AE

PROVIDER: S-EPMC6372949 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Fine particulate matters: The impact of air quality standards on cardiovascular mortality.

Corrigan Anne E AE Becker Michelle M MM Neas Lucas M LM Cascio Wayne E WE Rappold Ana G AG

Environmental research 20171201

<h4>Background</h4>In 1997 the U.S. Environmental Protection Agency set the first annual National Ambient Air Quality Standard (NAAQS) for fine particulate matter (PM<sub>2.5</sub>). Although the weight of scientific evidence has determined that a causal relationship exists between PM<sub>2.5</sub> exposures and cardiovascular effects, few studies have concluded whether NAAQS-related reductions in PM<sub>2.5</sub> led to improvements in public health.<h4>Methods</h4>We examined the change in car ...[more]

PMID: 29195185

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Project description:Ambient air pollution is a health concern in Latin America given its large urban population exposed to levels above recommended guidelines. Yet no studies have examined the mortality impact of air pollutants in the region across a wide range of cities. We assessed whether short-term levels of fine particulate matter (PM2.5) from modeled estimates, are associated with cardiovascular and respiratory mortality among adults in 337 cities from 9 Latin American countries. We compiled mortality, PM2.5 and temperature data for the period 2009-2015. For each city, we evaluated the association between monthly changes in PM2.5 and cardiovascular and respiratory mortality for sex and age subgroups using Poisson models, adjusted for seasonality, long-term trend, and temperature. To accommodate possibly different associations of mortality with PM2.5 by age, we included interaction terms between changes in PM2.5 and age in the models. We combined the city-specific estimates using a random effects meta-regression to obtain mortality relative risks for each sex and age group. We analyzed 3,026,861 and 1,222,623 cardiovascular and respiratory deaths, respectively, from a study population that represents 41 % of the total population of Latin America. We observed that a 10 μg/m3 increase in monthly PM2.5 is associated with an increase of 1.3 % (95 % confidence interval [CI], 0.4 to 2.2) in cardiovascular mortality and a 0.9 % increase (95 % CI -0.6 to 2.4) in respiratory mortality. Increases in mortality risk ranged between -0.5 % to 3.0 % across 6 sex-age groups, were larger in men, and demonstrated stronger associations with cardiovascular mortality as age increased. Socioeconomic, environmental and health contexts in Latin America are different than those present in higher income cities from which most evidence on air pollution impacts is drawn. Locally generated evidence constitutes a powerful instrument to engage civil society and help drive actions to mitigate and control ambient air pollution.

Project description:BackgroundEvidence indicates that air pollution contributes to cardiopulmonary mortality. There is ongoing debate regarding the size and shape of the pollution–mortality exposure–response relationship. There are also growing appeals for estimates of pollution–mortality relationships that use public data and are based on large, representative study cohorts.ObjectivesOur goal was to evaluate fine particulate matter air pollution ([Formula: see text]) and mortality using a large cohort that is representative of the U.S. population and is based on public data. Additional objectives included exploring model sensitivity, evaluating relative effects across selected subgroups, and assessing the shape of the [Formula: see text]–mortality relationship.MethodsNational Health Interview Surveys (1986–2014), with mortality linkage through 2015, were used to create a cohort of 1,599,329 U.S. adults and a subcohort with information on smoking and body mass index (BMI) of 635,539 adults. Data were linked with modeled ambient [Formula: see text] at the census-tract level. Cox proportional hazards models were used to estimate [Formula: see text]–mortality hazard ratios for all-cause and specific causes of death while controlling for individual risk factors and regional and urban versus rural differences. Sensitivity and subgroup analyses were conducted and the shape of the [Formula: see text]–mortality relationship was explored.ResultsEstimated mortality hazard ratios, per [Formula: see text] long-term exposure to [Formula: see text], were 1.12 (95% CI: 1.08, 1.15) for all-cause mortality, 1.23 (95% CI: 1.17, 1.29) for cardiopulmonary mortality, and 1.12 (95% CI: 1.00, 1.26) for lung cancer mortality. In general, [Formula: see text]–mortality associations were consistently positive for all-cause and cardiopulmonary mortality across key modeling choices and across subgroups of sex, age, race-ethnicity, income, education levels, and geographic regions.DiscussionThis large, nationwide, representative cohort of U.S. adults provides robust evidence that long-term [Formula: see text] exposure contributes to cardiopulmonary mortality risk. The ubiquitous and involuntary nature of exposures and the broadly observed effects across subpopulations underscore the public health importance of breathing clean air. https://doi.org/10.1289/EHP4438.

Dataset Information

Fine particulate matters: The impact of air quality standards on cardiovascular mortality.

Background

Methods

Findings

Interpretation

Funding

Publications

Fine particulate matters: The impact of air quality standards on cardiovascular mortality.

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