Dataset Information

The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach.

ABSTRACT:

Background

To date, few studies have investigated the causal relationship between mortality and long-term exposure to a low level of fine particulate matter (PM2.5) concentrations.

Methods and findings

We studied 242,320 registered deaths in Queensland between January 1, 1998, and December 31, 2013, with satellite-retrieved annual average PM2.5 concentrations to each postcode. A variant of difference-in-differences (DID) approach was used to investigate the association of long-term PM2.5 exposure with total mortality and cause-specific (cardiovascular, respiratory, and non-accidental) mortality. We observed 217,510 non-accidental deaths, 133,661 cardiovascular deaths, and 30,748 respiratory deaths in Queensland during the study period. The annual average PM2.5 concentrations ranged from 1.6 to 9.0 ?g/m3, which were well below the current World Health Organization (WHO) annual standard (10 ?g/m3). Long-term exposure to PM2.5 was associated with increased total mortality and cause-specific mortality. For each 1 ?g/m3 increase in annual PM2.5, we found a 2.02% (95% CI 1.41%-2.63%; p < 0.01) increase in total mortality. Higher effect estimates were observed in Brisbane than those in Queensland for all types of mortality. A major limitation of our study is that the DID design is under the assumption that no predictors other than seasonal temperature exhibit different spatial-temporal variations in relation to PM2.5 exposure. However, if this assumption is violated (e.g., socioeconomic status [SES] and outdoor physical activities), the DID design is still subject to confounding.

Conclusions

Long-term exposure to PM2.5 was associated with total, non-accidental, cardiovascular, and respiratory mortality in Queensland, Australia, where PM2.5 levels were measured well below the WHO air quality standard.

SUBMITTER: Yu W

PROVIDER: S-EPMC7302440 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach.

Yu Wenhua W Guo Yuming Y Shi Liuhua L Li Shanshan S

PLoS medicine 20200618 6

<h4>Background</h4>To date, few studies have investigated the causal relationship between mortality and long-term exposure to a low level of fine particulate matter (PM2.5) concentrations.<h4>Methods and findings</h4>We studied 242,320 registered deaths in Queensland between January 1, 1998, and December 31, 2013, with satellite-retrieved annual average PM2.5 concentrations to each postcode. A variant of difference-in-differences (DID) approach was used to investigate the association of long-ter ...[more]

PMID: 32555635

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Project description:Background and aimsPolicy makers and health system managers are seeking evidence on the risks involved for patients associated with after-hours care. This study of approximately 1 million patients who were admitted to the 25 largest public hospitals in Queensland Australia sought to quantify mortality and readmission differences associated with after-hours hospital admission.MethodsLogistic regression was used to assess whether there were any differences in mortality and readmissions based on the time inpatients were admitted to hospital (after-hours versus within hours). Patient and staffing data, including the variation in physician and nursing staff numbers and seniority were included as explicit predictors within patient outcome models.ResultsAfter adjusting for case-mix confounding, statistically significant higher mortality was observed for patients admitted on weekends via the hospital's emergency department compared to within hours. This finding of elevated mortality risk after-hours held true in sensitivity analyses which explored broader definitions of after-hours care: an "Extended" definition comprising a weekend extending into Friday night and early Monday morning; and a "Twilight" definition comprising weekends and weeknights.There were no significant differences in 30-day readmissions for emergency or elective patients admitted after-hours. Increased mortality risks for elective patients was found to be an evening/weekend effect rather than a day-of-week effect. Workforce metrics that played a role in observed outcome differences within hours/after-hours were more a time of day rather than day of week effect, i.e. staffing impacts differ more between day and night than the weekday versus weekend.ConclusionPatients admitted after-hours have significantly higher mortality than patients admitted within hours. This study confirms an association between mortality differences and the time patients were admitted to hospital, and identifies characteristics of patients and staffing that affect those outcomes.

Dataset Information

The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach.

Background

Methods and findings

Conclusions

Publications

The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach.

Similar Datasets

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