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BACKGROUND: Evidence of health risks associated with ambient airborne fine particles in nonurban populations is extremely limited. OBJECTIVE: We estimated the risk of hospitalization associated with short-term exposures to particulate matter with an aerodynamic diameter < 2.5 μm (PM 2.5) in urban and nonurban counties with population ≥ 50,000. METHODS: We utilized a database of daily cardiovascular- and respiratory-related hospitalization rates constructed from Medicare National Claims History files (2002-2006), including 28 million Medicare beneficiaries in 708 counties. Daily PM 2.5 exposures were estimated using the Community Multiscale Air Quality (CMAQ) downscaler. We used time-series analysis of hospitalization rates and PM 2.5 to evaluate associations between PM 2.5levels and hospitalization risk in single-pollutant models. RESULTS: We observed an association between cardiovascular hospitalizations and same-day PM 2.5 with higher risk in urban counties: 0.35% [95% posterior interval (PI): -0.71%, 1.41%] and 0.98% (95% PI: 0.73%, 1.23%) increases in hospitalization risk per 10-μg/m[sup 3] increment in PM 2.5 were observed in the least-urban and most-urban counties, respectively. The largest association for respiratory hospitalizations, a 2.57% (95% PI: 0.87%, 4.30%) increase per 10-μg/m3 increase in PM 2.5, was observed in the least-urban counties; in the most-urban counties, a 1.13% (0.73%, 1.54%) increase was observed. Effect estimates for cardiovascular hospitalizations were highest for smaller lag times, whereas effect estimates for respiratory hospitalizations increased as more days of exposure were included. CONCLUSION: In nonurban counties with population ≥ 50,000, exposure to PM 2.5 is associated with increased risk for respiratory hospitalizations; in urban counties, exposure is associated with increased risk of cardiovascular hospitalizations. Effect estimates based on a single day of exposure may underestimate true effects for respiratory hospitalizations. CITATION: Bravo MA, Ebisu K, Dominici F, Wang Y, Peng RD, Bell ML. 2017. Airborne fine particles and risk of hospital admissions for understudied populations: effects by urbanicity and short-term cumulative exposures in 708 U.S. counties. Environ Health Perspect 125:594-601; http://dx.doi.org/10.1289/EHP257 [ABSTRACT FROM AUTHOR]

BACKGROUND: Short-term exposure to ambient fine particulate matter (PM2.5) concentrations has been associated with increased mortality and morbidity. Determining which sources of PM2.5 are most toxic can help guide targeted reduction of PM2.5. However, conducting multicity epidemiologic studies of sources is difficult because source-specific PM2.5 is not directly measured, and source chemical compositions can vary between cities. OBJECTIVES: We determined how the chemical composition of primary ambient PM2.5 sources varies across cities. We estimated associations between source-specific PM2.5 and respiratory disease emergency department (ED) visits and examined between-city heterogeneity in estimated associations. METHODS: We used source apportionment to estimate daily concentrations of primary source-specific PM2.5 for four U.S. cities. For sources with similar chemical compositions between cities, we applied Poisson time-series regression models to estimate associations between source-specific PM2.5 and respiratory disease ED visits. RESULTS: We found that PM2.5 from biomass burning, diesel vehicle, gasoline vehicle, and dust sources was similar in chemical composition between cities, but PM2.5 from coal combustion and metal sources varied across cities. We found some evidence of positive associations of respiratory disease ED visits with biomass burning PM2.5; associations with diesel and gasoline PM2.5 were frequently imprecise or consistent with the null. We found little evidence of associations with dust PM2.5 CONCLUSIONS: We introduced an approach for comparing the chemical compositions of PM2.5 sources across cities and conducted one of the first multicity studies of source-specific PM2.5 and ED visits. Across four U.S. cities, among the primary PM2.5 sources assessed, biomass burning PM2.5 was most strongly associated with respiratory health. CITATION: Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. 2017. Associations between source-specific fine particulate matter and emergency department visits for respiratory disease in four U.S. cities. Environ Health Perspect 125:97-103; http://dx.doi.org/10.1289/EHP271 [ABSTRACT FROM AUTHOR]

BACKGROUND: Outdoor fine particulate matter (≤ 2.5 µm; PM2.5) has been identified as a global health threat, but the number of large U.S. prospective cohort studies with individual participant data remains limited, especially at lower recent exposures. OBJECTIVES: We aimed to test the relationship between long-term exposure PM2.5 and death risk from all nonaccidental causes, cardiovascular (CVD), and respiratory diseases in 517,041 men and women enrolled in the National Institutes of Health-AARP cohort. METHODS: Individual participant data were linked with residence PM2.5 exposure estimates across the continental United States for a 2000-2009 follow-up period when matching census tract-level PM2.5 exposure data were available. Participants enrolled ranged from 50 to 71 years of age, residing in six U.S. states and two cities. Cox proportional hazard models yielded hazard ratio (HR) estimates per 10 µg/m³ of PM2.5 exposure. RESULTS: PM2.5 exposure was significantly associated with total mortality (HR = 1.03; 95% CI: 1.00, 1.05) and CVD mortality (HR = 1.10; 95% CI: 1.05, 1.15), but the association with respiratory mortality was not statistically significant (HR = 1.05; 95% CI: 0.98, 1.13). A significant association was found with respiratory mortality only among never smokers (HR = 1.27; 95% CI: 1.03, 1.56). Associations with 10-µg/m³ PM2.5 exposures in yearly participant residential annual mean, or in metropolitan area-wide mean, were consistent with baseline exposure model results. Associations with PM2.5 were similar when adjusted for ozone exposures. Analyses of California residents alone also yielded statistically significant PM2.5 mortality HRs for total and CVD mortality. CONCLUSIONS: Long-term exposure to PM2.5 air pollution was associated with an increased risk of total and CVD mortality, providing an independent test of the PM2.5-mortality relationship in a new large U.S. prospective cohort experiencing lower post-2000 PM2.5 exposure levels. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years a number of studies have examined the short-term association between coarse particulate matter (PM10-2.5) and mortality and morbidity outcomes. These studies, however, have produced inconsistent conclusions. OBJECTIVES: We estimated both the national- and regional-level associations between PM10-2.5 and emergency hospitalizations for both cardiovascular and respiratory disease among Medicare enrollees ≥ 65 years of age during the 12-year period 1999 through 2010. METHODS: Using air pollution data obtained from the U.S. Environmental Protection Agency air quality monitoring network and daily emergency hospitalizations for 110 large urban U.S. counties assembled from the Medicare Cohort Air Pollution Study (MCAPS), we estimated the association between short-term exposure to PM10-2.5 and hospitalizations using a two-stage Bayesian hierarchical model and Poisson log-linear regression models. RESULTS: A 10-µg/m³ increase in PM10-2.5 was associated with a significant increase in same-day cardiovascular hospitalizations [0.69%; 95% posterior interval (PI): 0.45, 0.92]. After adjusting for PM2.5, this association remained significant (0.63%; 95% PI: 0.38, 0.88). A 10-µg/m³ increase in PM10-2.5 was not associated with a significant increase in respiratory-related hospitalizations. CONCLUSIONS: We found statistically significant evidence that daily variation in PM10-2.5 is associated with emergency hospitalizations for cardiovascular diseases among Medicare enrollees ≥ 65 years of age. This association was robust to adjustment for concentrations of PM2.5. [ABSTRACT FROM AUTHOR]

BACKGROUND: Population-based studies have estimated health risks of short-term exposure to fine particles using mass of PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter) as the indicator. Evidence regarding the toxicity of the chemical components of the PM2.5 mixture is limited. OBJECTIVE: In this study we investigated the association between hospital admission for cardiovascular disease (CVD) and respiratory disease and the chemical components of PM2.5 in the United States. METHODS: We used a national database comprising daily data for 2000-2006 on emergency hospital admissions for cardiovascular and respiratory outcomes, ambient levels of major PM2.5 chemical components [sulfate, nitrate, silicon, elemental carbon (EC), organic carbon matter (OCM), and sodium and ammonium ions], and weather. Using Bayesian hierarchical statistical models, we estimated the associations between daily levels of PM2.5 components and risk of hospital admissions in 119 U.S. urban communities for 12 million Medicare enrollees (≥ 65 years of age). RESULTS: In multiple-pollutant models that adjust for the levels of other pollutants, an interquartile range (IQR) increase in EC was associated with a 0.80% [95% posterior interval (PI), 0.34-1.27%] increase in risk of same-day cardiovascular admissions, and an IQR increase in OCM was associated with a 1.01% (95% PI, 0.04-1.98%) increase in risk of respiratory admissions on the same day. Other components were not associated with cardiovascular or respiratory hospital admissions in multiple-pollutant models. CONCLUSIONS: Ambient levels of EC and OCM, which are generated primarily from vehicle emissions, diesel, and wood burning, were associated with the largest risks of emergency hospitalization across the major chemical constituents of PM2.5. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vermiculite from the mine near Libby, Montana, is contaminated with tremolite asbestos and other amphibole fibers (winchite and richterite). Asbestos-contaminated Libby vermiculite was used in loose-fill attic insulation that remains in millions of homes in the United States, Canada, and other countries. OBJECTIVE: This report describes asbestos-related occupational respiratory disease mortality among workers who mined, milled, and processed the Libby vermiculite. METHODS: This historical cohort mortality study uses life table analysis methods to compare the age-adjusted mortality experience through 2001 of 1,672 Libby workers to that of white men in the U.S. population. RESULTS: Libby workers were significantly more likely to die from asbestosis [standardized mortality ratio (SMR) = 165.8; 95% confidence interval (CI), 103.9-251.1], lung cancer (SMR = 1.7; 95% CI, 1.4-2.1), cancer of the pleura (SMR = 23.3; 95% CI, 6.3-59.5), and mesothelioma. Mortality from asbestosis and lung cancer increased with increasing duration and cumulative exposure to airborne tremolite asbestos and other amphibole fibers. CONCLUSIONS: The observed dose-related increases in asbestosis and lung cancer mortality highlight the need for better understanding and control of exposures that may occur when homeowners or construction workers (including plumbers, cable installers, electricians, telephone repair personnel, and insulators) disturb loose-fill attic insulation made with asbestos-contaminated vermiculite from Libby, Montana. [ABSTRACT FROM AUTHOR]

BACKGROUND: Volatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes. OBJECTIVE: We examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function. METHODS: We used data from 953 adult participants (20–59 years of age) in the Third National Health and Nutrition Examination Survey (1988–1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function. RESULTS: After adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of -153 mL [95% confidence interval (CI), -297 to -8] in forced expiratory volume in 1 sec and -346 mL/sec (95% CI, -667 to -24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile. CONCLUSIONS: Exposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health. [ABSTRACT FROM AUTHOR]

Rates of developmental and respiratory diseases are disproportionately high in underserved, minority populations such as those in New York City's Washington Heights, Harlem, and the South Bronx. Blacks and Latinos in these neighborhoods represent high risk groups for asthma, adverse birth outcomes, impaired development, and some types of cancer. The Columbia Center for Children's Environmental Health in Washington Heights uses molecular epidemiologic methods to study the health effects of urban indoor and outdoor air pollutants on children, prenatally and postnatally, in a cohort of over 500 African-American and Dominican (originally from the Dominican Republic) mothers and newborns. Extensive data are collected to determine exposures to paniculate matter < 2.5 µm in aerodynamic diameter (PM[sub2.5]), polycyclic aromatic hydrocarbons (PAHs), diesel exhaust paniculate (DEP), nitrogen oxide, nonpersistent pesticides, home allergens (dust mite, mouse, cockroach), environmental tobacco smoke (ETS), and lead and other metals. Biomarkers, air sampling, and clinical assessments are used to study the effects of these exposures on children's increased risk for allergic sensitization, asthma and other respiratory disorders, impairment of neurocognitive and behavioral development, and potential cancer risk. The center conducts its research and community education in collaboration with 10 community-based health and environmental advocacy organizations. This unique academic-community partnership helps to guide the center's research so that it is most relevant to the context of the low-income, minority neighborhoods in which the cohort resides, and information is delivered back to these communities in meaningful ways. In turn, communities become better equipped to relay environmental health concerns to policy makers. In this paper we describe the center's research and its academic-community partnership and present some preliminary findings. Key words: asthma, cancer... [ABSTRACT FROM AUTHOR]

Presents a time-series analysis of acidic particulate matter and daily mortality and morbidity in the region of Buffalo, New York. Consideration of daily aerosol acidity and sulfate measurements from May 1988 to October 1990; Associations with respiratory hospital admissions.

Investigates the correlation between ozone exposure and respiratory health of nonsmoking young adults in New Haven, Connecticut. Recruitment and measurement protocols used; Assessment of ozone exposure; Evidence for diminished lung function following ozone exposure.

Cites a study published in the March, 2002 issue of the 'European Respiratory Journal,' conducted by University of California researchers to evaluate the cost of medical care given to people with chronic respiratory diseases. Average of total annual medical care costs for people with respiratory conditions; Advantage of policies that lead to improvement in respiratory health.

Focuses on the health risks of cyanobacteria exposure, a toxin released by blue-green alae in the United States. Demonstration of a potential tumor-producing property; Correlation with respiratory illness; Issue on the use of blue-green algae supplements.

The article discusses the inadequacy of current environmental protection standards relating to the health hazards posed by the ozone levels in the atmosphere. Ozone has been known to be a common urban pollutant and has been correlated to health effects including reduced lung function, increases in respiratory symptoms, and asthma. A study was released in 2006 indicating that ozone may pose a danger to human health even at levels below the limits set by current U.S. and international regulations.

Reports on a study conducted by U.S. researchers which suggests that riding diesel-fueled buses may increase children's risk for cancer and aggravate respiratory problems. High rate of interior exhaust concentrations inside the diesel-fueled buses; Limitations of the study; Advantage of using alternative fuels by school buses; Ways to reduce emissions by buses using diesel fuel.