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      Associations of PM 2.5 Constituents and Sources with Hospital Admissions: Analysis of Four Counties in Connecticut and Massachusetts (USA) for Persons ≥ 65 Years of Age

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          Abstract

          Background: Epidemiological studies have demonstrated associations between short-term exposure to PM 2.5 and hospital admissions. The chemical composition of particles varies across locations and time periods. Identifying the most harmful constituents and sources is an important health and regulatory concern.

          Objectives: We examined pollutant sources for associations with risk of hospital admissions for cardiovascular and respiratory causes.

          Methods: We obtained PM 2.5 filter samples for four counties in Connecticut and Massachusetts and analyzed them for PM 2.5 elements. Source apportionment was used to estimate daily PM 2.5 contributions from sources (traffic, road dust, oil combustion, and sea salt as well as a regional source representing coal combustion and other sources). Associations between daily PM 2.5 constituents and sources and risk of cardiovascular and respiratory hospitalizations for the Medicare population (> 333,000 persons ≥ 65 years of age) were estimated with time-series analyses (August 2000–February 2004).

          Results: PM 2.5 total mass and PM 2.5 road dust contribution were associated with cardiovascular hospitalizations, as were the PM 2.5 constituents calcium, black carbon, vanadium, and zinc. For respiratory hospitalizations, associations were observed with PM 2.5 road dust, and sea salt as well as aluminum, calcium, chlorine, black carbon, nickel, silicon, titanium, and vanadium. Effect estimates were generally robust to adjustment by co-pollutants of other constituents. An interquartile range increase in same-day PM 2.5 road dust (1.71 μg/m 3) was associated with a 2.11% (95% CI: 1.09, 3.15%) and 3.47% (95% CI: 2.03, 4.94%) increase in cardiovascular and respiratory admissions, respectively.

          Conclusions: Our results suggest some particle sources and constituents are more harmful than others and that in this Connecticut/Massachusetts region the most harmful particles include black carbon, calcium, and road dust PM 2.5.

          Citation: Bell ML, Ebisu K, Leaderer BP, Gent JF, Lee HJ, Koutrakis P, Wang Y, Dominici F, Peng RD. 2014. Associations of PM 2.5 constituents and sources with hospital admissions: analysis of four counties in Connecticut and Massachusetts (USA) for persons ≥ 65 years of age. Environ Health Perspect 122:138–144;  http://dx.doi.org/10.1289/ehp.1306656

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          Health effects of fine particulate air pollution: lines that connect.

          D W Dockery, C Pope (2006)
          Efforts to understand and mitigate thehealth effects of particulate matter (PM) air pollutionhave a rich and interesting history. This review focuseson six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There hasbeen substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidiity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonaryhealth. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.
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            An Estimate of the Global Burden of Anthropogenic Ozone and Fine Particulate Matter on Premature Human Mortality Using Atmospheric Modeling

            Susan Anenberg, Larry W. Horowitz, Daniel Tong … (2010)
            Background Ground-level concentrations of ozone (O3) and fine particulate matter [≤ 2.5 μm in aerodynamic diameter (PM2.5)] have increased since preindustrial times in urban and rural regions and are associated with cardiovascular and respiratory mortality. Objectives We estimated the global burden of mortality due to O3 and PM2.5 from anthropogenic emissions using global atmospheric chemical transport model simulations of preindustrial and present-day (2000) concentrations to derive exposure estimates. Methods Attributable mortalities were estimated using health impact functions based on long-term relative risk estimates for O3 and PM2.5 from the epidemiology literature. Using simulated concentrations rather than previous methods based on measurements allows the inclusion of rural areas where measurements are often unavailable and avoids making assumptions for background air pollution. Results Anthropogenic O3 was associated with an estimated 0.7 ± 0.3 million respiratory mortalities (6.3 ± 3.0 million years of life lost) annually. Anthropogenic PM2.5 was associated with 3.5 ± 0.9 million cardiopulmonary and 220,000 ± 80,000 lung cancer mortalities (30 ± 7.6 million years of life lost) annually. Mortality estimates were reduced approximately 30% when we assumed low-concentration thresholds of 33.3 ppb for O3 and 5.8 μg/m3 for PM2.5. These estimates were sensitive to concentration thresholds and concentration–mortality relationships, often by > 50%. Conclusions Anthropogenic O3 and PM2.5 contribute substantially to global premature mortality. PM2.5 mortality estimates are about 50% higher than previous measurement-based estimates based on common assumptions, mainly because of methodologic differences. Specifically, we included rural populations, suggesting higher estimates; however, the coarse resolution of the global atmospheric model may underestimate urban PM2.5 exposures.
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              Spatial and Temporal Variation in PM2.5 Chemical Composition in the United States for Health Effects Studies

              Michelle L. Bell, Francesca Dominici, Keita Ebisu … (2007)
              Background Although numerous studies have demonstrated links between particulate matter (PM) and adverse health effects, the chemical components of the PM mixture that cause injury are unknown. Objectives This work characterizes spatial and temporal variability of PM2.5 (PM with aerodynamic diameter < 2.5 μm) components in the United States; our objective is to identify components for assessment in epidemiologic studies. Methods We constructed a database of 52 PM2.5 component concentrations for 187 U.S. counties for 2000–2005. First, we describe the challenges inherent to analysis of a national PM2.5 chemical composition database. Second, we identify components that contribute substantially to and/or co-vary with PM2.5 total mass. Third, we characterize the seasonal and regional variability of targeted components. Results Strong seasonal and geographic variations in PM2.5 chemical composition are identified. Only seven of the 52 components contributed ≥ 1% to total mass for yearly or seasonal averages [ammonium (NH4 +), elemental carbon (EC), organic carbon matter (OCM), nitrate (NO3 −), silicon, sodium (Na+), and sulfate (SO4 2−)]. Strongest correlations with PM2.5 total mass were with NH4 + (yearly), OCM (especially winter), NO3 − (winter), and SO4 2− (yearly, spring, autumn, and summer), with particularly strong correlations for NH4 + and SO4 2− in summer. Components that co-varied with PM2.5 total mass, based on daily detrended data, were NH4 +, SO4 2− , OCM, NO3 2−, bromine, and EC. Conclusions The subset of identified PM2.5 components should be investigated further to determine whether their daily variation is associated with daily variation of health indicators, and whether their seasonal and regional patterns can explain the seasonal and regional heterogeneity in PM10 (PM with aerodynamic diameter < 10 μm) and PM2.5 health risks.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Environ Health Perspect
                Journal ID (iso-abbrev): Environ. Health Perspect
                Journal ID (publisher-id): EHP
                Title: Environmental Health Perspectives
                Publisher: National Institute of Environmental Health Sciences
                ISSN (Print): 0091-6765
                ISSN (Electronic): 1552-9924
                Publication date (Electronic): 08 November 2013
                Publication date (Print): February 2014
                Volume: 122
                Issue: 2
                Pages: 138-144
                Affiliations
                [1 ]School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
                [2 ]Yale Center for Perinatal, Pediatric and Environmental Epidemiology, School of Public Health, Yale University, New Haven, Connecticut, USA
                [3 ]Department of Environmental Health, and
                [4 ]Department of Biostatistics, School of Public Health, Harvard University, Boston, Massachusetts, USA
                [5 ]Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
                Author notes
                Address correspondence to M. Bell, Yale University, 195 Prospect St., New Haven, Connecticut 06511 USA. Telephone: (203) 432-9869. E-mail: michelle.bell@ 123456yale.edu
                Article
                Publisher ID: ehp.1306656
                DOI: 10.1289/ehp.1306656
                PMC ID: 3915260
                PubMed ID: 24213019
                SO-VID: f7988c42-53e0-4282-8fb4-032fcf326d6b
                License:

                Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.

                History
                Date received : 15 February 2013
                Date accepted : 06 November 2013
                Date: 08 November 2013
                Date: 01 February 2014
                Categories
                Subject: Research

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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