Low-level PM2.5 exposure, Cardiovascular and Non-accidental Mortality, and Related Health Disparities in 12 U.S. States

Adjani A Peralta; Edgar Castro; Mahdieh Danesh Yazdi; Anna Kosheleva; Yaguang Wei; Joel Schwartz

doi:10.1097/EDE.0000000000001820

Low-level PM2.5 exposure, Cardiovascular and Non-accidental Mortality, and Related Health Disparities in 12 U.S. States

Epidemiology. 2024 Nov 22. doi: 10.1097/EDE.0000000000001820. Online ahead of print.

Authors

Adjani A Peralta¹, Edgar Castro¹, Mahdieh Danesh Yazdi², Anna Kosheleva¹, Yaguang Wei^{1

3}, Joel Schwartz^{1

4}

Affiliations

¹ Department of Environmental Health; Harvard T.H. Chan School of Public Health, Boston, USA.
² Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony brook, New York, USA.
³ Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, USA.
⁴ Department of Epidemiology; Harvard T.H. Chan School of Public Health, Boston, USA.

PMID: 39575927
DOI: 10.1097/EDE.0000000000001820

Abstract

Background: Investigations into long-term fine particulate matter (PM2.5) exposure's impact on non-accidental and cardiovascular (CVD) deaths primarily involve non-representative adult populations at concentrations above the new EPA annual PM2.5 standard.

Methods: Using generalized linear models, we studied PM2.5 exposure on rates of five mortality outcomes (all non-accidental, CVD, myocardial infarction (MI), stroke, and congestive heart failure (CHF)) in 12 US States from 2000-2016. We aggregated predicted annual PM2.5 exposures from a validated ensemble exposure model, ambient temperature from Daymet predictions, and mortality rates to all Census tract-years within the States. We obtained covariates from the decennial Census and the American Community Surveys and assessed effect measure modification by race and education with stratification.

Results: For each 1-ug/m3 increase in annual PM2.5, we found positive associations with all five mortality outcomes: all non-accidental (1.08%; 95% CI: 0.96%, 1.20%), all CVD (1.27%; 95% CI: 1.14%, 1.41%), MI (1.89%; 95% CI: 1.67%, 2.11%), stroke (1.08%; 95% CI: 0.87%, 1.30%) and CHF (2.20%; 95% CI: 1.97%, 2.44%). Positive associations persisted at <8 ug/m3 PM2.5 levels and among populations with only under 65. In our study, race, but not education, modifies associations. High-educated Black had a 2.90% larger increased risk of CVD mortality (95% CI: 2.42%, 3.39%) compared to low-educated non-Black.

Conclusion: Long-term PM2.5 exposure is associated with non-accidental and CVD mortality in 12 states, below the new EPA standard, for both low PM2.5 regions and the general population. Vulnerability to CVD mortality persists among Black individuals regardless of education level.