title: The Association between Dust Storms and Daily Non-Accidental Mortality in the United States, 1993-2005.
abstract: BACKGROUND
  The impact of dust storms on human health has been studied in the context of Asian, Saharan, Arabian, and Australian storms, but there has been no recent population-level epidemiological research on the dust storms in North America. The relevance of dust storms to public health is likely to increase as extreme weather events are predicted to become more frequent with anticipated changes in climate through the 21st century.
  
  
  OBJECTIVE
  We examined the association between dust storms and county-level non-accidental mortality in the United States from 1993 through 2005.
  
  
  METHODS
  Dust storm incidence data, including date and approximate location, are taken from the U.S. National Weather Service storm database. County-level mortality data for the years 1993-2005 were acquired from the National Center for Health Statistics. Distributed lag conditional logistic regression models under a time-stratified case-crossover design were used to study the relationship between dust storms and daily mortality counts over the whole United States and in Arizona and California specifically. End points included total non-accidental mortality and three mortality subgroups (cardiovascular, respiratory, and other non-accidental).
  
  
  RESULTS
  We estimated that for the United States as a whole, total non-accidental mortality increased by 7.4% (95% CI: 1.6, 13.5; p = 0.011) and 6.7% (95% CI: 1.1, 12.6; p = 0.018) at 2- and 3-day lags, respectively, and by an average of 2.7% (95% CI: 0.4, 5.1; p = 0.023) over lags 0-5 compared with referent days. Significant associations with non-accidental mortality were estimated for California (lag 2 and 0-5 day) and Arizona (lag 3), for cardiovascular mortality in the United States (lag 2) and Arizona (lag 3), and for other non-accidental mortality in California (lags 1-3 and 0-5).
  
  
  CONCLUSIONS
  Dust storms are associated with increases in lagged non-accidental and cardiovascular mortality. Citation: Crooks JL, Cascio WE, Percy MS, Reyes J, Neas LM, Hilborn ED. 2016. The association between dust storms and daily non-accidental mortality in the United States, 1993-2005. Environ Health Perspect 124:1735-1743; http://dx.doi.org/10.1289/EHP216.
authors.affiliation: Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Chapel Hill, North Carolina, USA.
authors.forename: James Lewis
authors.initials: JL
authors.lastname: Crooks
authors.forename: Wayne E
authors.initials: WE
authors.lastname: Cascio
authors.forename: Madelyn S
authors.initials: MS
authors.lastname: Percy
authors.forename: Jeanette
authors.initials: J
authors.lastname: Reyes
authors.forename: Lucas M
authors.initials: LM
authors.lastname: Neas
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Hilborn
mesh_terms: D004391:Dust; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D052638:Particulate Matter / Q000633:toxicity*; D014481:United States / Q000453:epidemiology; D014887:Weather; D014919:Wind
chemical_list: D004391:Dust; D052638:Particulate Matter