Abstract
There is a well-documented association between ambient fine particulate matter air pollution (PM2.5) and cardiovascular disease (CVD) morbidity and mortality. Exposure to PM2.5 can cause premature death and harmful and chronic health effects such as heart attack, diabetes, and stroke. The Environmental Protection Agency sets annual PM2.5 standards to reduce these negative health effects. Currently above an annual average level of 12.0 µg/m is considered unhealthy. Methods. We examined the association of long-term exposure to PM2.5 and CVD in a cohort of 44,610 individuals who resided in 12 states recruited into the Southern Community Cohort Study (SCCS). The SCCS was designed to recruit Black and White participants who received care from Federally Qualified Health Centers; hence, they represent vulnerable individuals from low-income families across this vast region. This study tests whether SCCS participants who lived in locations exposed to elevated ambient levels of PM2.5 concentrations were more likely to report a history of CVD at enrollment (2002–2009). Remotely sensed satellite data integrated with ground monitoring data provide an assessment of the average annual PM2.5 in urban and rural locations where the SCCS participants resided. We used multilevel logistic regression to estimate the associations between self-reported CVD and exposure to elevated ambient levels of PM2.5. Results. We found a 13.4 percent increase in the odds of reported CVD with exposure to unhealthy levels of PM2.5 exposure at enrollment. The SCCS participants with medical histories of hypertension, hypercholesterolemia, and smoking had, overall, 385 percent higher odds of reported CVD than those without these clinical risk factors. Additionally, Black participants were more likely to live in locations with higher ambient PM2.5 concentrations and report high levels of clinical risk factors, thus, they may be at a greater future risk of CVD. Conclusions: In the SCCS participants, we found a strong relation between exposures to high ambient levels of PM2.5 and self-reported CVD at enrollment.
Highlights
The U.S Clean Air Act requires the Environmental Protection Agency (EPA) to set National Ambient Air Quality Standards for “criteria air pollutants,” including carbon monoxide, lead, ground-level ozone, nitrogen dioxide, sulfur dioxide, and particulate matter
Our findings indicate that participants in the Southern Community Cohort Study (SCCS) at enrollment report 13.4% more
Black people may be at higher risk of cardiovascular disease (CVD) [21], about 10% higher odds after accounting for social characteristics and medical history
Summary
The U.S Clean Air Act requires the EPA to set National Ambient Air Quality Standards for “criteria air pollutants,” including carbon monoxide, lead, ground-level ozone, nitrogen dioxide, sulfur dioxide, and particulate matter. These pollutants can cause property damage and harm the environment and an individual’s health. The mortality from cardiovascular disease (CVD) such as stroke, diabetes, heart attack, and many other chronic illnesses tend to be higher among Black people than other populations in the United States [3]
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