Background In recent years (2000 to 2007), ambient levels of fine particulate matter (PM2.5) have continued to decline as a result of interventions, but the decline has been at a slower rate than previous years (1980 to 2000). Whether these more recent and slower declines of PM2.5 levels continue to improve life expectancy and whether they benefit all populations equally is unknown. Methods We assembled a dataset for 545 U.S. counties consisting of yearly county-specific average PM2.5, yearly county-specific life expectancy, and several potentially confounding variables measuring socioeconomic status, smoking prevalence and demographic characteristics for the years 2000 and 2007. We used regression models to estimate the association between reductions in PM2.5 and changes in life expectancy for the period 2000 to 2007. Results A decrease of 10 µg/m3 in the concentration of PM2.5 was associated with an increase in mean life expectancy of 0.35 years SD= 0.16 years, p = 0.033). This association was stronger in more urban and densely populated counties. Conclusions Reductions in PM2.5 were associated with improvements in life expectancy for the period 2000 to 2007. Air pollution control in the last decade has continued to have a positive impact on public health.

Objective To investigate whether exposure to aircraft noise increases the risk of hospitalization for cardiovascular diseases in older people (≥65 years) residing near airports.Design Multi-airport retrospective study of approximately 6 million older people residing near airports in the United States. We superimposed contours of aircraft noise levels (in decibels, dB) for 89 airports for 2009 provided by the US Federal Aviation Administration on census block resolution population data to construct two exposure metrics applicable to zip code resolution health insurance data: population weighted noise within each zip code, and 90th centile of noise among populated census blocks within each zip code.Setting 2218 zip codes surrounding 89 airports in the contiguous states.Participants 6 027 363 people eligible to participate in the national medical insurance (Medicare) program (aged ≥65 years) residing near airports in 2009. Main outcome measuresPercentage increase in the hospitalization admission rate for cardiovascular disease associated with a 10 dB increase in aircraft noise, for each airport and on average across airports adjusted by individual level characteristics (age, sex, race), zip code level socioeconomic status and demographics, zip code level air pollution (fine particulate matter and ozone), and roadway density.Results Averaged across all airports and using the 90th centile noise exposure metric, a zip code with 10 dB higher noise exposure had a 3.5% higher (95% confidence interval 0.2% to 7.0%) cardiovascular hospital admission rate, after controlling for covariates.Conclusions Despite limitations related to potential misclassification of exposure, we found a statistically significant association between exposure to aircraft noise and risk of hospitalization for cardiovascular diseases among older people living near airports.

Background The extent to which relative contributions of traditional cardiovascular factors risk to incident cardiovascular disease (CVD) may have changed over time remains unclear. Methods and Results We studied 13,541 participants (56% women, 26% black) in the Atherosclerosis Risk in Communities Study, aged 52-66 years and free of CVD at exams in 1987-89, 1990-92, 1993-95, or 1996-98. At each exam, we estimated the population attributable risks (PAR) of traditional risk factors (hypertension, diabetes, obesity, hypercholesterolemia, and smoking) for the 10-year incidence of CVD. Overall, the PAR of all risk factors combined appeared to decrease from 1987-89 to 1996-98 (0.58 to 0.53). The combined PAR was higher in women than men in 1987-89 (0.68 vs. 0.51, P<0.001) but not by 1996-98 (0.58 vs. 0.48, P=0.08). The combined PAR was higher in blacks than whites in 1987-89 (0.67 vs. 0.57, P=0.049), and this difference was more pronounced by 1996-98 (0.67 vs. 0.48, P=0.002). By 1996-98, the PAR of hypertension had become higher in women than men (P=0.02) and also appeared higher in blacks than whites (P=0.08). By 1996-98, the PAR of diabetes remained higher in women than men (P<0.0001) and in blacks than whites (P<0.0001). Conclusions The contribution to CVD of all traditional risk factors combined is greater in blacks than whites, and this difference may be increasing. The contributions of hypertension and diabetes remain especially high, in women as well as blacks. These findings underscore the continued need for individual as well as population approaches to CVD risk factor modification.