Fine particulate air pollution and its components in association with cause-specific emergency admissions.
BACKGROUND
Although the association between exposure to particulate matter and health is well established, there remains uncertainty as to whether certain chemical components are more harmful than others. We explored whether the association between cause-specific hospital admissions and PM(2.5) was modified by PM(2.5) chemical composition.


METHODS
We estimated the association between daily PM(2.5) and emergency hospital admissions for cardiac causes (CVD), myocardial infarction (MI), congestive heart failure (CHF), respiratory disease, and diabetes in 26 US communities, for the years 2000-2003. Using meta-regression, we examined how this association was modified by season- and community-specific PM(2.5) composition, controlling for seasonal temperature as a surrogate for ventilation.


RESULTS
For a 10 microg/m3 increase in 2-day averaged PM(2.5) concentration we found an increase of 1.89% (95% CI: 1.34- 2.45) in CVD, 2.25% (95% CI: 1.10- 3.42) in MI, 1.85% (95% CI: 1.19- 2.51) in CHF, 2.74% (95% CI: 1.30- 4.2) in diabetes, and 2.07% (95% CI: 1.20- 2.95) in respiratory admissions. The association between PM2.5 and CVD admissions was significantly modified when the mass was high in Br, Cr, Ni, and Na(+), while mass high in As, Cr, Mn, OC, Ni, and Na(+) modified MI, and mass high in As, OC, and SO(4)(2-) modified diabetes admissions. For these species, an interquartile range increase in their relative proportion was associated with a 1-2% additional increase in daily admissions per 10 microg/m(3) increase in mass.


CONCLUSIONS
We found that PM(2.5) mass higher in Ni, As, and Cr, as well as Br and OC significantly increased its effect on hospital admissions. This result suggests that particles from industrial combustion sources and traffic may, on average, have greater toxicity.
Zanobetti
Antonella
A
Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, USA. azanobet@hsph.harvard.edu
Franklin
Meredith
M
Koutrakis
Petros
P
Schwartz
Joel
J
D000368:Aged; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D013696:Temperature; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D001335:Vehicle Emissions
D052638:Particulate Matter; D001335:Vehicle Emissions