title: Association of long-term PM2.5 exposure with mortality using different air pollution exposure models: impacts in rural and urban California.
abstract: Most PM2.5-associated mortality studies are not conducted in rural areas where mortality rates may differ when population characteristics, health care access, and PM2.5 composition differ. PM2.5-associated mortality was investigated in the elderly residing in rural-urban zip codes. Exposure (2000-2006) was estimated using different models and Poisson regression was performed using 2006 mortality data. PM2.5 models estimated comparable exposures, although subtle differences were observed in rate ratios (RR) within areas by health outcomes. Cardiovascular disease (CVD), ischemic heart disease (IHD), and cardiopulmonary disease (CPD), mortality was significantly associated with rural, urban, and statewide chronic PM2.5 exposures. We observed larger effect sizes in RRs for CVD, CPD, and all-cause (AC) with similar sizes for IHD mortality in rural areas compared to urban areas. PM2.5 was significantly associated with AC mortality in rural areas and statewide; however, in urban areas, only the most restrictive exposure model showed an association. Given the results seen, future mortality studies should consider adjusting for differences with rural-urban variables.
authors.affiliation: a California Air Resources Board, Research Division , Sacramento , CA , USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Garcia
authors.affiliation: a California Air Resources Board, Research Division , Sacramento , CA , USA.
authors.forename: Poh-Sin
authors.initials: PS
authors.lastname: Yap
authors.affiliation: a California Air Resources Board, Research Division , Sacramento , CA , USA.
authors.forename: Hye-Youn
authors.initials: HY
authors.lastname: Park
authors.affiliation: a California Air Resources Board, Research Division , Sacramento , CA , USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Weller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000633:toxicity*; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality*; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000379:methods*; D006801:Humans; D008962:Models, Theoretical; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000401:mortality; D052638:Particulate Matter / Q000633:toxicity*; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000401:mortality*; D012424:Rural Population; D014505:Urban Population
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: air pollution; cardiovascular; fine particles; mortality; rural