Long-Term PM2.5 Exposure and Respiratory, Cancer, and Cardiovascular Mortality in Older US Adults

Abstract

The impact of chronic exposure to fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5)) on respiratory disease and lung cancer mortality is poorly understood. In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living across the conterminous United States between 2000 and 2008, we examined the association between chronic PM2.5 exposure and cause-specific mortality. We evaluated confounding through adjustment for neighborhood behavioral covariates and decomposition of PM2.5 into 2 spatiotemporal scales. We found significantly positive associations of 12-month moving average PM2.5 exposures (per 10-μg/m3 increase) with respiratory, chronic obstructive pulmonary disease, and pneumonia mortality, with risk ratios ranging from 1.10 to 1.24. We also found significant PM2.5-associated elevated risks for cardiovascular and lung cancer mortality. Risk ratios generally increased with longer moving averages; for example, an elevation in 60-month moving average PM2.5 exposures was linked to 1.33 times the lung cancer mortality risk (95% confidence interval: 1.24, 1.40), as compared with 1.13 (95% confidence interval: 1.11, 1.15) for 12-month moving average exposures. Observed associations were robust in multivariable models, although evidence of unmeasured confounding remained. In this large cohort of US elderly, we provide important new evidence that long-term PM2.5 exposure is significantly related to increased mortality from respiratory disease, lung cancer, and cardiovascular disease.

Air Pollution and Cardiovascular Disease: a Focus on Vulnerable Populations Worldwide

“…Elderly populations are among the most vulnerable to the risk of adverse cardiovascular outcomes from air pollution [94, 95]. For subclinical CVD, Kaufman et al found that the association of long-term exposure to PM 2.5 with increased annual CAC progression was somewhat stronger among individuals older than 65 years of age compared to younger individuals [10••].…”

“…Results were no longer significant when the entire ESCAPE cohort, including younger adults, were analyzed. Finally, in a large cohort of 18.9 million Medicare beneficiaries from across the US, Pun et al observed an increased risk for cardiovascular mortality with exposures to long-term PM 2.5 [95]. …”

Mitochondrial dysfunction in endothelial cells induced by airborne fine particulate matter (<2.5 μm)

“…Epidemiologic studies have indicated that the increased morbidity or mortality of cardiovascular diseases is correlated with ambient PM 2.5 pollution (Pope et al, ; Pun, Kazemiparkouhi, Manjourides, & Suh, ). PM 2.5 can be inhaled into the airway and deposited in lung alveoli, where the toxic component of PM 2.5 may penetrate into the systemic circulation, triggering and aggravating cardiovascular system diseases (Deng, Rui, Zhang, & Ding, ).…”

Extensive evaluation and classification of low‐cost dust sensors in laboratory using a newly developed test method

“…Air pollution associated with PM concentrations has been studied significantly on its adverse effects . Fine airborne particles, PM 2.5 (particle size less than or equal to 2.5 μm), have been considered one of the highest health risks, causing numerous diseases including lung cancer, arrhythmia, asthma, pneumonitis, and cardiovascular mortality . The first key factor for effective management of air pollution is to continuously monitor air quality by measuring PM concentrations.…”