A National Multicity Analysis of the Causal Effect of Local Pollution, NO2, and PM2.5 on Mortality

Schwartz, Joel; Fong, Kelvin C.; Zanobetti, Antonella

doi:10.1289/ehp2732

Cited by 62 publications

(27 citation statements)

References 60 publications

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“…The general magnitude of our results aligns with previous studies [19,20], but there is inconsistency among results that have been reported thus far between various studies and even within the same study using different causal methods. Using IV analysis, Schwartz et al found a 1.54% increase in daily deaths per 10 μg/m 3 PM 2.5 increase.…”

Section: Discussionsupporting

confidence: 91%

“…Using IV analysis, Schwartz et al found a 1.54% increase in daily deaths per 10 μg/m 3 PM 2.5 increase. In contrast, they reported that the marginal structural model estimate for PM 2.5 was 0.75% for the same increment [19]. In another study by Schwartz et al 2015, a 0.5% daily mortality increase was reported to be a result of a 1 μg/m 3 PM 2.5 increase using IV and propensity score methods [20].…”

Section: Discussionmentioning

confidence: 93%

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The impact of PM2.5 on mortality in older adults: evidence from retirement of coal-fired power plants in the United States

Fan

Wang

2020

Environ Health

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Background: Evidence of causal relationship between mortality of older adults and low-concentration PM 2.5 remains limited. Objectives: This study investigates the effects of low-concentration PM 2.5 on the mortality of adults older than 65 using the closure of coal-fired power plants in the Eastern United States as a natural experiment. Methods: We investigated power plants in the Eastern United States (US) that had production changes through unit shutdown or plant retirement between 1999 and 2013. We included only non-clustered power plants without scrubbers and with capacities greater than 50 MW. We used instrumental variable (IV) and difference-indifferences (DID) approaches to estimate the causal impact of PM 2.5 concentrations on mortality among Medicare beneficiaries. We compared changes in monthly age-adjusted mortality before and after the retirement of coal-fired plants between the treated and control counties; we accounted for annual wind direction in our selection of treated and control counties. In the models, we initially included only county and monthly fixed effects, and then adjusted for covariates including: 1) only weather variables (temperature, dew point, pressure); and 2) weather variables and socioeconomic variables (median household income and poverty rate). Results: The monthly age-adjusted mortality rate averaged across all plants was approximately 423 per 100,000 (SD = 69) and was higher for males than females. Mean PM 2.5 concentrations across all counties were 12 μg/m 3 (SD = 3.78). Using the IV method, we found that reductions in PM 2.5 concentrations significantly decreased monthly mortality among older adults. IV results show that a 1-μg/m 3 reduction in PM 2.5 concentrations leads to 7.17 fewer deaths per 100,000 per month, or a 1.7% lower monthly mortality rate among people older than 65 years. Using the DID approach, we found that power plant retirement significantly decreased: 1) monthly PM 2.5 levels by 2.1 μg/m 3 , and 2) monthly age-adjusted mortality by approximately 15 people per 100,000 (or 3.6%) in treated counties relative to control counties. The mortality effects were higher among males than females and its impact was the greatest among people older than 75 years. Conclusion: These findings provide evidence of the effectiveness of local, plant-level control measures in reducing near-plant PM 2.5 and mortality among U.S. Medicare beneficiaries.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

The impact of PM2.5 on mortality in older adults: evidence from retirement of coal-fired power plants in the United States

Fan

Wang

2020

Environ Health

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“…Thus, while effects of NO 2 appear to be confounded by co-pollutants, there is still evidence of an association after accounting for this. In a recent causalmodelling analysis of NO 2 , PM 2.5 and mortality in 135 US cities, Schwartz et al concluded that NO 2 was independently associated with mortality, although residual confounding by other pollutants could not be ruled out [7]. Similarly, in their systematic review and metaanalysis attempting to distinguish effects of particulate matter and NO 2 on mortality and hospital admissions in time-series studies, Mills et al concluded that effects of NO 2 were generally robust to inclusion of particulate In the absence of publication bias, points should be symmetrically distributed around the vertical line, with smaller studies (larger standard errors on vertical axis) more widely scattered.…”

Section: Overall Rating Of Quality and Strength Of Evidencementioning

confidence: 99%

“…A particular complicating factor is whether NO 2 itself is to blame, or whether it is simply acting as a marker for specific air pollution sources i.e. emissions from vehicles [6,7]. Carbon monoxide and certain chemical components of fine particulate matter, also primarily originating from vehicle emissions, are key potential confounders, given their well-established pathophysiological mechanisms of action on cardiac ischemia [8].…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity

et al. 2020

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Background: Nitrogen dioxide (NO 2) is a pervasive urban pollutant originating primarily from vehicle emissions. Ischemic heart disease (IHD) is associated with a considerable public health burden worldwide, but whether NO 2 exposure is causally related to IHD morbidity remains in question. Our objective was to determine whether short term exposure to outdoor NO 2 is causally associated with IHD-related morbidity based on a synthesis of findings from case-crossover and time-series studies. Methods: MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I 2 measures, and sources of heterogeneity were evaluated using metaregression. Sensitivity of pooled estimates to individual studies was examined using Leave One Out analysis and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill.

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“…In terms of exposure assessment, 15 studies used PM 2.5 estimated from spatio-temporal prediction models [2••, 3, 7, 8, 17, 18, 21, 22••, 23-25, 27-30], two [13,14] used the EPA Downscaler (DS) model [31], five used PM 2.5 concentrations measured at monitoring stations and downloaded from EPA's Air Quality System (AQS) database or other county monitors [10,15,16,19,26], two used measurements from the Harvard Supersite in Boston [12,20], and two studies compared results obtained using five [11] and ten [9] different exposure models. In terms of exposure duration, 15 studies examined mean annual PM 2.5 , ten studies daily PM 2.5 , and one study included both daily and annual averaged exposures.…”

Section: Summary Of Findingsmentioning

confidence: 99%

Low Levels of Air Pollution and Health: Effect Estimates, Methodological Challenges, and Future Directions

Papadogeorgou

Kioumourtzoglou

Braun

et al. 2019

Curr Envir Health Rpt

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Purpose of Review-Fine particle (PM 2.5) levels have been decreasing in the USA over the past decades. Our goal was to assess the current literature to characterize the association between PM 2.5 and adverse health at low exposure levels. Recent Findings-We reviewed 26 papers that examined the association between short-and long-term exposure to PM 2.5 and cardio-respiratory morbidity and mortality. There is evidence suggesting that these associations are stronger at lower levels. However, there are certain methodological and interpretational limitations specific to studies of low PM 2.5 levels, and further methodological development is warranted. Summary-There is strong agreement across studies that air pollution effects on adverse health are still observable at low concentrations, even well below current US standards. These findings suggest that US standards need to be reevaluated, given that further improving air quality has the potential of benefiting public health.

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A National Multicity Analysis of the Causal Effect of Local Pollution, NO2, and PM2.5 on Mortality

Abstract: Causal-modeling techniques, each subject to different assumptions, demonstrated causal effects of locally generated pollutants on daily deaths with effects at concentrations below the current EPA daily [Formula: see text] standard. https://doi.org/10.1289/EHP2732.

Cited by 62 publications

References 60 publications

The impact of PM2.5 on mortality in older adults: evidence from retirement of coal-fired power plants in the United States

The impact of PM2.5 on mortality in older adults: evidence from retirement of coal-fired power plants in the United States

Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity

Low Levels of Air Pollution and Health: Effect Estimates, Methodological Challenges, and Future Directions

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