The Relationship of Ambient Fine Particulate Pollution (PM2.5) and Cardiovascular Disease Hospitalizations

Abstract

Objectives: To evaluate the association between cardiovascular disease hospitalizationsand short term changes in PM2.5 in states enrolled in the CDC Environmental Health Tracking Program. A total of 11 states are participating in the study. Methods: Daily 24-hour average PM2.5 and 8-hour maximum ozone levels were obtained from EPA modeled data. A Bayesian space-time downscaler model is used to fuse monitoring data from AQS with gridded output from EPA’s Community Multiscale Air Quality (CMAQ) model. State data stewards provided in-patient hospitalization data(and for some also ED data) for 2001-2008. A time stratified case-crossover design was used to estimate the effects of PM2.5 on non-elective hospitalizations for circulatorydiseases (ICD-9 390-459). Odds ratios/95% CIs were calculated for a 10 microgram/m3increase in PM2.5 using conditional logistic regression and adjusting for temperature, dew point, and ozone. Subcategories of cardiovascular disease (CVD), including acute myocardial infarction, stroke, congestive heart failure, and cardiac dysrhythmias, were also examined. Results: Preliminary findings show that in New Jersey, a 10 µg/m3 increase of PM2.5 on the day of admission was associated with a significant increase in circulatory diseasehospitalizations. (OR=1.013, 95%CI 1.009,1.016). Increases in PM2.5 levels were also significantly associated with hospitalizations due to acute myocardial infarction(OR=1.014; 95%CI=1.003,1.026) and congestive heart failure (OR=1.028, 95% CI1.018,1.037). Further work will be presented for hospitalizations and ED visits in additional participating states to include Florida, Massachusetts, New Hampshire, New Mexico, New York, Utah, and Washington. Conclusions: This study demonstrated the use of EPA modeled PM2.5 estimates to examine short term effects of PM2.5 on cardiovascular hospitalizations.