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Importance: Despite biological plausibility, very few epidemiologic studies have investigated the risks of clinically significant bleeding events due to particulate air pollution., Objective: To measure the independent and synergistic effects of PM 2.5 exposure and anticoagulant use on serious bleeding events., Design: Retrospective cohort study (2008-2016)., Setting: Nationwide Medicare population., Participants: A 50% random sample of Medicare Part D-eligible Fee-for-Service beneficiaries at high risk for cardiovascular and thromboembolic events., Exposures: Fine particulate matter (PM 2.5 ) and anticoagulant drugs (apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin)., Main Outcomes and Measures: The outcomes were acute hospitalizations for gastrointestinal bleeding, intracranial bleeding, or epistaxis. Hazard ratios and 95% CIs for PM 2.5 exposure were estimated by fitting inverse probability weighted marginal structural Cox proportional hazards models. The relative excess risk due to interaction was used to assess additive-scale interaction between PM 2.5 exposure and anticoagulant use., Results: The study cohort included 1.86 million high-risk older adults (mean age 77, 60% male, 87% White, 8% Black, 30% anticoagulant users, mean PM 2.5 exposure 8.81 μg/m 3 ). A 10 μg/m 3 increase in PM 2.5 was associated with a 48% (95% CI: 45%-52%), 58% (95% CI: 49%-68%) and 55% (95% CI: 37%-76%) increased risk of gastrointestinal bleeding, intracranial bleeding, and epistaxis, respectively. Significant additive interaction between PM 2.5 exposure and anticoagulant use was observed for gastrointestinal and intracranial bleeding., Conclusions: Among older adults at high risk for cardiovascular and thromboembolic events, increasing PM 2.5 exposure was significantly associated with increased risk of gastrointestinal bleeding, intracranial bleeding, and epistaxis. In addition, PM 2.5 exposure and anticoagulant use may act together to increase risks of severe gastrointestinal and intracranial bleeding. Thus, clinicians may recommend that high-risk individuals limit their outdoor air pollution exposure during periods of increased PM 2.5 concentrations. Our findings may inform environmental policies to protect the health of vulnerable populations., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rachel C. Nethery reports financial support was provided by National Institutes of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Co-exposure to air pollution and neighborhood disadvantage may influence cognition decline. We tested these associations in the context of dementia risk., Methods: We leveraged a cohort of adults ≥65 years (n = 5397) enrolled from 2011 to 2018 in the National Health and Aging Trends Study (NHATS). Particulate matter (PM) ≤ 10 μm in diameter, PM ≤ 2.5 μm in diameter, carbon monoxide, nitric oxide, and nitrogen dioxide - and neighborhood disadvantage were tested for joint associations with dementia risk. Pollutant concentrations at the 2010 census tract level were assigned using the US Environmental Protection Agency's Community Multiscale Air Quality Modeling System. Neighborhood disadvantage was defined using the tract Social Deprivation Index (SDI). Dementia was determined through self- or proxy-report or scores indicative of "probable dementia" according to NHATS screening tools. Joint effects of air pollutants and SDI were tested using quantile g-computation Cox proportional hazards models. We also stratified joint air pollution effects across SDI tertiles. Analyses adjusted for age at enrollment, sex, education, partner status, urbanicity, income, race and ethnicity, years at residence, census segregation, and census region., Results: SDI score (aHR = 1.08; 95% CI 0.96, 1.22), joint air pollution (aHR = 1.03, 95% CI 0.92, 1.16) and joint SDI with air pollution (aHR = 1.04, 95% CI 0.89, 1.22) were not associated with dementia risk. After accounting for competing risk of death, joint SDI with air pollution was not associated with dementia risk (aHR = 1.06; 95% CI 0.87, 1.29). In stratified models, joint air pollution was associated with greater risk of dementia at high (aHR = 1.19; 95% CI 0.87, 1.63), but not at medium or low SDI., Conclusion: Air pollution was associated with greater dementia risk in disadvantaged areas after accounting for competing risks. Air pollution associations with dementia incidence may be attenuated when other risk factors are more prominent in disadvantaged neighborhoods., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Aisha S. Dickerson reports financial support was provided by National Institute of Environmental Health Sciences. Aisha S. Dickerson reports financial support was provided by Bloomberg American Health Initiative. Roland J. Thorpe, Jr. reports financial support was provided by National Institute on Aging. Roland J. Thorpe, Jr. reports financial support was provided by National Institute on Minority Health and Health Disparities. Cavin Ward-Caviness reports a relationship with Clock Foundation that includes: board membership. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Preterm birth (PTB) is a predictor of infant mortality and later-life morbidity. Despite recent declines, PTB rates remain high in the United States. Growing research suggests a possible relationship between a mother's exposure to common air pollutants, including fine particulate matter (PM 2.5 ), and PTB of her baby. Many policy actions to reduce exposure to common air pollutants require benefit-cost analysis (BCA), and it's possible that PTB will need to be included in BCA in the future. However, an estimate of the willingness to pay (WTP) to avoid PTB risk is not available, and a comprehensive alternative valuation of the health benefits of reducing pollutant-related PTB currently does not exist. This paper demonstrates an approach to assess potential economic benefits of reducing PTB resulting from environmental exposures when an estimate of WTP to avoid PTB risk is unavailable. We utilized a recent meta-analysis, county-level air quality data and county-level PTB prevalence data to estimate the potential health and economic benefits of a reduction in air pollution-related PTB, with PM 2.5 as our case study pollutant. Using this method, a simulated nationwide 10% decrease from 2008 PM 2.5 levels resulted in an estimated reduction of 5016 PTBs and benefits of at least $339 million, potentially reaching over one billion dollars when considering later-life effects of PTB., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Mounting evidence over the past several decades has demonstrated inequitable distribution of pollutants of ambient origin between sociodemographic groups in the United States. Most environmental inequality studies to date are cross-sectional and used proximity-based methods rather than modeled air pollution concentrations, limiting the ability to examine trends over time or the factors that drive exposure inequalities. In this paper, we use 1 km 2 modeled PM 2.5 and NO 2 concentrations in Massachusetts over an 8-year period and Census demographic data to quantify inequality between sociodemographic groups and to develop a more nuanced understanding of the drivers and trends in longitudinal air pollution inequality. Annual-average population-weighted PM 2.5 and NO 2 concentrations were highest for urban non-Hispanic black populations (11.8 µg/m 3 in 2003 and 8.4 µg/m 3 in 2010, vs. 11.3 µg/m 3 and 8.1 µg/m 3 for urban non-Hispanic whites) and urban Hispanic populations (15.9 ppb in 2005 and 13.0 ppb in 2010, vs. 13.0 ppb and 10.2 ppb for urban non-Hispanic whites), respectively. While population groups experienced similar absolute decreases in exposure over time, disparities in population-weighted concentrations increased over time when quantified by the Atkinson Index, a relative inequality measure. Exposure inequalities were approximately one order of magnitude greater for NO 2 compared to PM 2.5 , were more pronounced in urban compared to rural geographies, and between racial/ethnic groups compared to income and educational attainment groups. Our results also revealed similar longitudinal PM 2.5 and NO 2 inequality trends using Census 2000 and Census 2010 data, indicating that spatio-temporal shifts in air pollution may best explain observed trends in inequality. These findings enhance our understanding of factors that contribute to persistent inequalities and underscore the importance of targeted exposure reduction strategies aimed at vulnerable populations and neighborhoods. [ABSTRACT FROM AUTHOR]

The effectiveness of air pollution emission control policies can be evaluated by examining ambient pollutant concentration trends that are observed at a large number of ground monitoring sites over time. In this paper, we used ground monitoring measurements in conjunction with satellite aerosol optical depth (AOD) data to investigate fine particulate matter (PM 2.5 ; particulate matter with aerodynamic diameter≤2.5 µm) trends and their spatial patterns over a large U.S. region, New England, during 2000–2008. We examined the trends in rural and urban areas to get a better insight about the trends of regional and local source emissions. Decreases in PM 2.5 concentrations (µg/m 3 ) were more pronounced in urban areas than in rural ones. In addition, the highest and lowest PM 2.5 decreases (µg/m 3 ) were observed for winter and summer, respectively. Together, these findings suggest that primary particle concentrations decreased more relative to secondary ones. This is also supported by the analysis of the speciation data which showed that downward trends of primary pollutants including black carbon were stronger than those of secondary pollutants including sulfate. Furthermore, this study found that ambient primary pollutants decreased at the same rate as their respective source emissions. This was not the case for secondary pollutants which decreased at a slower rate than that of their precursor emissions. This indicates that concentrations of secondary pollutants depend not only on the primary emissions but also on the availability of atmospheric oxidants which might not change during the study period. This novel approach of investigating spatially varying concentration trends, in combination with ground PM 2.5 species trends, can be of substantial regulatory importance. [ABSTRACT FROM AUTHOR]