Dataset Information

PM_2.5 and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

ABSTRACT:

Background

Although long-term exposure to particulate matter<2.5 μm (PM_2.5) has been linked to chronic debilitating brain disorders (CDBD), the role of short-term exposure in health care demand, and increased susceptibility for PM_2.5-related health conditions, among Medicare enrollees with CDBD has received little attention. We used a causal modeling approach to assess the effect of short-term high PM_2.5 exposure on all-cause admissions, and prevalent cause-specific admissions among Medicare enrollees with CDBD (Parkinson's disease-PD, Alzheimer's disease-AD and other dementia).

Methods

We constructed daily zipcode counts of hospital admissions of Medicare beneficiaries older than 65 across the United-States (2000-2014). We obtained daily PM_2.5 estimates from a satellite-based model. A propensity score matching approach was applied to match high-pollution (PM_2.5 > 17.4 μg/m³) to low-pollution zip code-days with similar background characteristics. Then, we estimated the percent change in admissions attributable to high pollution. We repeated the models restricting the analysis to zipcode-days with PM_2.5 below of 35 μg/m³.

Results

We observed significant increases in all-cause hospital admissions (2.53% in PD and 2.49% in AD/dementia) attributable to high PM_2.5 exposure. The largest observed effect for common causes was for pneumonia and urinary tract infection. All the effects were larger in CDBD compared to the general Medicare population, and similarly strong at levels of exposure considered safe by the EPA.

Conclusion

We found Medicare beneficiaries with CDBD to be at higher risk of being admitted to the hospital following acute exposure to PM_2.5 levels well below the National Ambient Air Quality Standard defined as safe by the EPA.

SUBMITTER: Yitshak-Sade M

PROVIDER: S-EPMC7749824 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

PM<sub>2.5</sub> and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

Yitshak-Sade Maayan M Nethery Rachel R Schwartz Joel D JD Mealli Fabrizia F Dominici Francesca F Di Qian Q Abu Awad Yara Y Ifergane Gal G Zanobetti Antonella A

The Science of the total environment 20201003 Pt 2

<h4>Background</h4>Although long-term exposure to particulate matter<2.5 μm (PM<sub>2.5</sub>) has been linked to chronic debilitating brain disorders (CDBD), the role of short-term exposure in health care demand, and increased susceptibility for PM<sub>2.5</sub>-related health conditions, among Medicare enrollees with CDBD has received little attention. We used a causal modeling approach to assess the effect of short-term high PM<sub>2.5</sub> exposure on all-cause admissions, and prevalent cau ...[more]

PMID: 33065503

Similar Datasets

Project description:BackgroundPositive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of a megalopolis. In addition, most studies in China have used averaged data, which results in variations between monitoring and personal exposure values, creating an inherent and unavoidable type of measurement error.MethodsThis study was conducted in Wuhan, a megacity in central China with about 10.9 million people. Daily hospital admission records, from October 2016 to December 2018, were obtained from the Wuhan Information center of Health and Family Planning, which administrates all hospitals in Wuhan. Daily air pollution concentrations and weather variables in Wuhan during the study period were collected. We developed a land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposure to PM2.5. We also conducted stratification analyses by age, sex, and season.ResultsA total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 cardiovascular disease admissions and 159,365 respiratory disease admissions. Short-term exposure to PM2.5 was associated with an increased risk of a cardiorespiratory hospital admission. A 10 μg/m3 increase in PM2.5 (lag0-2 days) was associated with an increase in hospital admissions of 1.23% (95% CI 1.01-1.45%) and 1.95% (95% CI 1.63-2.27%) for cardiovascular and respiratory diseases, respectively. The elderly were at higher PM-induced risk. The associations appeared to be more evident in the cold season than in the warm season.ConclusionsThis study contributes evidence of short-term effects of PM2.5 on cardiorespiratory hospital admissions, which may be helpful for air pollution control and disease prevention in Wuhan.

Project description:PM2.5 can cause adverse health effects via several pathways, such as inducing pulmonary and systemic inflammation, penetration into circulation, and activation of the autonomic nervous system. In particular, the impact of PM2.5 exposure on the liver, which plays an important role in metabolism and detoxification to maintain internal environment homeostasis, is getting more attention in recent years. In the present study, C57BL/6J mice were randomly assigned and treated with PM2.5 suspension and PBS solution for 8 weeks. Then, hepatic tissue was prepared and identified by metabolomics analysis and transcriptomics analysis. PM2.5 exposure can cause extensive metabolic disturbances, particularly in lipid and amino acids metabolic dysregulation.128 differential expression metabolites (DEMs) and 502 differently expressed genes (DEGs) between the PM2.5 exposure group and control group were detected. The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that DEGs were significantly enriched in two disease pathways, non-alcoholic fatty liver disease (NAFLD) and type II diabetes mellitus (T2DM), and three signaling pathways, which are TGF-beta signaling, AMPK signaling, and mTOR signaling. Besides, further detection of acylcarnitine levels revealed accumulation in liver tissue, which caused restricted lipid consumption. Furthermore, lipid droplet accumulation in the liver was confirmed by Oil Red O staining, suggesting hepatic steatosis. Moreover, the aberrant expression of three key transcription factors revealed the potential regulatory effects in lipid metabolic disorders, the peroxisomal proliferative agent-activated receptors (PPARs) including PPARα and PPARγ is inhibited, and the activated sterol regulator-binding protein 1 (SREBP1) is overexpressed. Our results provide a novel molecular and genetic basis for a better understanding of the mechanisms of PM2.5 exposure-induced hepatic metabolic diseases, especially in lipid metabolism.

Project description:IntroductionA causal link between air pollution exposure and cardiovascular events has been suggested. However fewer studies have investigated the shape of the associations at low levels of air pollution and identified the most important temporal window of exposure. Here we assessed long-term associations between particulate matter < 2.5 µm (PM2.5) at low concentrations and multiple cardiovascular endpoints using the UK Biobank cohort.MethodsUsing data on adults (aged > 40) from the UK Biobank cohort, we investigated the associations between 1-year, 3-year and 5-year time-varying averages of PM2.5 and incidence of major adverse cardiovascular events (MACE), myocardial infarction (MI), heart failure, atrial fibrillation and flutter and cardiac arrest. We also investigated outcome subtypes for MI and stroke. Events were defined as hospital inpatient admissions. We fitted Cox proportional hazard regression models applying extensive control for confounding at both individual and area level. Finally, we assessed the shape of the exposure-response functions to assess effects at low levels of exposure.ResultsWe analysed data from 377,736 study participants after exclusion of prevalent subjects. The average follow-up (2006-2021) was 12.9 years. We detected 19,353 cases of MACE, 6,562 of acute MI, 6,278 of heart failure, 1,258 for atrial fibrillation and flutter, and 16,327 for cardiac arrest. Using a 5-year exposure window, we detected positive associations (for 5 μg/m3 increase in PM2.5) for 5-point MACE of [1.12 (95 %CI: 1.00-1.26)], heart failure [1.22 (1.00-1.50)] and cardiac arrest [1.16 (1.03-1.31)]. We did not find any association with acute MI, while non-ST-elevation MI was associated with the 1-year exposure window [1.52 (1.12-2.07)]. The assessment of the shape of the exposure-response relationships suggested that risk is approximately linear for most of the outcomes.ConclusionsWe found positive associations between long-term exposure to PM2.5 and multiple cardiovascular outcomes for different exposure windows. The cardiovascular risk tends to rise even at exposure concentrations below 12-15 μg/m3, indicating high risk below UK national and international thresholds.

Project description:ObjectivePrevious epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM2.5) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM2.5 and circulatory system diseases in Ganzhou.MethodsWe conducted this time series study to explore the association between ambient PM2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season.ResultsBased on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m3 increase in PM2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%-4.035%), 2.773% (95% CI, 1.246%-4.324%), 2.865% (95% CI, 0.786%-4.893%), 1.691% (95% CI, 0.239%-3.165%), 4.173% (95% CI, 1.988%-6.404%) and 1.496% (95% CI, 0.030%-2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM2.5 levels. In subgroup analyses, the impacts of PM2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons.ConclusionPM2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM2.5.

Dataset Information

PM_2.5 and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

Background

Methods

Results

Conclusion

Publications

PM<sub>2.5</sub> and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

PM2.5 and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

Background

Methods

Results

Conclusion

Publications

PM<sub>2.5</sub> and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

PM_2.5 and hospital admissions among Medicare enrollees with chronic debilitating brain disorders.