Chronic Fine and Coarse Particulate Exposure, Mortality, and Coronary Heart Disease in the Nurses’ Health Study

Abstract

BackgroundThe relationship of fine particulate matter < 2.5 μm in diameter (PM2.5) air pollution with mortality and cardiovascular disease is well established, with more recent long-term studies reporting larger effect sizes than earlier long-term studies. Some studies have suggested the coarse fraction, particles between 2.5 and 10 μm (PM10–2.5), may also be important. With respect to mortality and cardiovascular events, questions remain regarding the relative strength of effect sizes for chronic exposure to fine and coarse particles.ObjectivesWe examined the relationship of chronic PM2.5 and PM10–2.5 exposures with all-cause mortality and fatal and nonfatal incident coronary heart disease (CHD), adjusting for time-varying covariates.MethodsThe current study included women from the Nurses’ Health Study living in metropolitan areas of the northeastern and midwestern United States. Follow-up was from 1992 to 2002. We used geographic information systems–based spatial smoothing models to estimate monthly exposures at each participant’s residence.ResultsWe found increased risk of all-cause mortality [hazard ratio (HR), 1.26; 95% confidence interval (CI), 1.02–1.54] and fatal CHD (HR = 2.02; 95% CI, 1.07–3.78) associated with each 10-μg/m3 increase in annual PM2.5 exposure. The association between fatal CHD and PM10–2.5 was weaker.ConclusionsOur findings contribute to growing evidence that chronic PM2.5 exposure is associated with risk of all-cause and cardiovascular mortality.

Data Issues and Suggestions in the National Health Insurance Service-National Sample Cohort for Assessing the Long-term Health Effects of Air Pollution Focusing on Mortality

“…These models and their previous use in assessing chronic PM exposures among the NHS cohort are described in detail elsewhere [3,[25][26][27][28][29]. Briefly, a PM 2.3 model was developed using monitor data from the US Environmental Protection Agency's (USEPA) Air Quality System (AQS), the IMPROVE network, and Harvard research studies.…”

“…Long-term exposures to ambient particulate air pollution have been associated with an increased risk of all-cause mortality in a number of studies [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. In a recent meta-analysis of cohort studies [6], each 10 μg/m 3 increase in particulate matter 2.5 μm or less in aerodynamic diameter (PM 2.5 ) was associated with a 6.2% (95% confidence interval 4.1-8.4%) increased risk of all-cause mortality.…”

Applying GIS Methods to Public Health Research at Harvard University

“…In an analysis conducted by Puett et al (2009), investigators examined the association of chronic particulate exposures with incident nonfatal myocardial infarction, fatal coronary heart disease (CHD), and all-cause mortality, in a prospective cohort of 66,250 women from the Nurses'…”

“…Health Study in northeastern United States (Puett 2009). Researchers developed a spatiotemporal model to estimate monthly PM10 and PM2.5 exposure between 1988 and 2002, using government monitoring data, geocoded residential addresses, and covariates calculated using GIS overlay analysis between addresses locations and census tract boundaries .…”

“…All multivariate models were also stratified by age in months and adjusted for state of residence (indicator variables), year (linear term), and season (indicator variables), in order to adjust for large-scale spatial mortality patterns which might be related to factors apart from pollution. increase in annual PM(2.5) exposure Puett 2009). Findings demonstrated that chronic PM(2.5) exposure was associated with risk of all-cause and cardiovascular mortality.…”