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Long-Term Exposure to Ambient PM2.5 and Hospitalizations for Myocardial Infarction Among US Residents: A
Yichen Wang1, Xinye Qiu1, Yaguang Wei1
1Department of Environmental Health Harvard T.H. Chan School of Public Health Boston MA.
Abstract:
Background Air pollution has been recognized as an untraditional risk factor for myocardial infarction (MI). However, the MI risk attributable to long-term exposure to fine particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) is unclear, especially in younger populations, and few studies have represented the general population or had power to examine comorbidities. Methods and Results We applied the difference-in-differences approach to estimate the relationship between annual PM2.5 exposure and hospitalizations for MI among US residents and further identified potential susceptible subpopulations. All hospital admissions for MI in 10 US states over the period 2002 to 2016 were obtained from the Healthcare Cost and Utilization Project State Inpatient Database. In total, 1 914 684 MI hospital admissions from 8106 zip codes were included in this study. We observed a 1.35% (95% CI, 1.11-1.59) increase in MI hospitalization rate for 1-μg/m3 increase in annual PM2.5 exposure. The estimate was robust to adjustment for surface pressure, relative humidity, and copollutants. In the population exposed to ≤12 μg/m3, there was a larger increment of 2.17% (95% CI, 1.79-2.56) in hospitalization rate associated with 1-μg/m3 increase in PM2.5. Young people (0-34 years of age) and elderly people (≥75 years of age) were the 2 most susceptible age groups. Residents living in more densely populated or poorer areas and individuals with comorbidities were observed to be at a greater risk. Conclusions This study indicates long-term residential exposure to PM2.5 could increase risk of MI among the general US population, people with comorbidities, and poorer individuals. The association persists below current standards.
Insights
Long-term exposure to fine particulate matter (PM2.5) increases myocardial infarction hospitalization risk in the US. This risk is higher for younger and older adults, those with existing health conditions, and residents of poorer areas.
Area of Science:
- Environmental Health
- Cardiovascular Epidemiology
- Public Health
Background:
- Air pollution is an emerging risk factor for myocardial infarction (MI).
- The specific risk of MI from long-term fine particulate matter (PM2.5) exposure, particularly in younger populations and the general US population, remains unclear.
- Few studies have adequately assessed the impact of PM2.5 on MI risk while considering comorbidities.
Purpose of the Study:
- To estimate the relationship between long-term PM2.5 exposure and MI hospitalizations in the US general population.
- To identify susceptible subpopulations at increased risk of MI due to PM2.5 exposure.
- To assess if the association between PM2.5 and MI persists below current air quality standards.
Main Methods:
- Utilized a difference-in-differences approach to analyze MI hospitalizations from the Healthcare Cost and Utilization Project State Inpatient Database (2002-2016) across 10 US states.
- Included 1,914,684 MI hospital admissions from 8,106 zip codes, linking them to annual average PM2.5 exposure data.
- Adjusted for environmental factors like surface pressure, relative humidity, and copollutants.
Main Results:
- A 1-μg/m³ increase in annual PM2.5 exposure was associated with a 1.35% rise in MI hospitalization rates.
- The association was stronger in populations exposed to ≤12 μg/m³ of PM2.5, showing a 2.17% increase per 1-μg/m³ rise.
- Younger (0-34 years) and older (≥75 years) age groups, individuals with comorbidities, and residents of poorer, densely populated areas exhibited higher susceptibility.
Conclusions:
- Long-term residential exposure to PM2.5 significantly increases the risk of MI in the general US population.
- Individuals with comorbidities and those residing in socioeconomically disadvantaged areas are at greater risk.
- The detrimental association between PM2.5 and MI risk is evident even at levels below current air quality standards.
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