1. Long-term exposure to PM 2.5 and incidence of disability in activities of daily living among oldest old.
- Author
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Lv Y, Zhou J, Kraus VB, Li T, Sarnat JA, Wang J, Liu Y, Chen H, Brasher MS, Mao C, Zeng Y, Zheng T, and Shi X
- Subjects
- Aged, 80 and over, Air Pollutants, China, Cities, Humans, Incidence, Activities of Daily Living, Air Pollution, Environmental Exposure statistics & numerical data, Particulate Matter
- Abstract
Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM
2.5 ) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM2.5 exposure with a threshold concentration of 33 μg/m3 , and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM2.5 concentrations; compared to 33 μg/m3 , the hazard ratio ranged from 1.03 (1.00-1.06) at 40 μg/m3 to 2.25 (1.54-3.29) at 110 μg/m3 . The risk magnitude was not significantly changed below this threshold. Each 10 μg/m3 increase in PM2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051-1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m3 , and supported that reduction to current World Health Organization interim target-1value (35 μg/m3 ) and Chinese national ambient air quality standards (35 μg/m3 ) or lower may be associated with lower risk of disability in ADL., (Copyright © 2020 Elsevier Ltd. All rights reserved.)- Published
- 2020
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