title: Associations of fine particulate matter species with mortality in the United States: a multicity time-series analysis.
abstract: BACKGROUND
  Epidemiological studies have examined the association between PM2.5 and mortality, but uncertainty remains about the seasonal variations in PM2.5-related effects and the relative importance of species.
  
  
  OBJECTIVE
  We estimated the effects of PM2.5 species on mortality and how infiltration rates may modify the association.
  
  
  METHODS
  Using city-season specific Poisson regression, we estimated PM2.5 effects on approximately 4.5 million deaths for all causes, cardiovascular disease (CVD), myocardial infarction (MI), stroke, and respiratory diseases in 75 U.S. cities for 2000-2006. We added interaction terms between PM2.5 and monthly average species-to-PM2.5 proportions of individual species to determine the relative toxicity of each species. We combined results across cities using multivariate meta-regression, and controlled for infiltration.
  
  
  RESULTS
  We estimated a 1.18% (95% CI: 0.93, 1.44%) increase in all-cause mortality, a 1.03% (95% CI: 0.65, 1.41%) increase in CVD, a 1.22% (95% CI: 0.62, 1.82%) increase in MI, a 1.76% (95% CI: 1.01, 2.52%) increase in stroke, and a 1.71% (95% CI: 1.06, 2.35%) increase in respiratory deaths in association with a 10-μg/m3 increase in 2-day averaged PM2.5 concentration. The associations were largest in the spring. Silicon, calcium, and sulfur were associated with more all-cause mortality, whereas sulfur was related to more respiratory deaths. County-level smoking and alcohol were associated with larger estimated PM2.5 effects.
  
  
  CONCLUSIONS
  Our study showed an increased risk of mortality associated with PM2.5, which varied with seasons and species. The results suggest that mass alone might not be sufficient to evaluate the health effects of particles.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Lingzhen
authors.initials: L
authors.lastname: Dai
authors.forename: Antonella
authors.initials: A
authors.lastname: Zanobetti
authors.forename: Petros
authors.initials: P
authors.lastname: Koutrakis
authors.forename: Joel D
authors.initials: JD
authors.lastname: Schwartz
mesh_terms: D000397:Air Pollution / Q000009:adverse effects; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D009026:Mortality; D052638:Particulate Matter / Q000009:adverse effects*; D014481:United States
chemical_list: D052638:Particulate Matter