Academic journal article Environmental Health Perspectives

Fine Particulate Matter Components and Emergency Department Visits for Cardiovascular and Respiratory Diseases in the St. Louis, Missouri-Illinois, Metropolitan Area

Academic journal article Environmental Health Perspectives

Fine Particulate Matter Components and Emergency Department Visits for Cardiovascular and Respiratory Diseases in the St. Louis, Missouri-Illinois, Metropolitan Area

Article excerpt

Introduction

Substantial epidemiologic evidence supports an association between ambient fine particulate ([PM.sub.2.5]; particulate matter with aerodynamic diameter [less than or equal to] 2.5 [micro]m) air pollution and acute cardiorespiratory health effects [U.S. Environmental Protection Agency (EPA) 2009]. Given that [PM.sub.2.5] is a mixture of multiple components, it has been of high interest to identify its specific health-relevant physical and/or chemical features to more effectively guide air pollution regulation (Dominici et al. 2010; National Research Council 2004). Recent reviews of the [PM.sub.2.5] toxicological and epidemiological literature (Chen and Lippmann 2009; Kelly and Fussell 2012; Reiss et al. 2007; Rohr and Wyzga 2012) provide some indication of differential toxicity across PM components, with stronger evidence for health effects of carbon-related components [e.g., organic carbon (OC) and elemental carbon (EC)] and some metals [e.g., nickel, vanadium, zinc (Zn), lead (Pb)] than secondary inorganic components [e.g., sulfate (S[O.sub.4.sup.2-]) and nitrate (N[O.sub.3.sup.-])]. However, studies have varied in their findings, perhaps for a number of factors, such as the specific components examined and differential measurement error among the components. Few epidemiological studies have assessed associations of health with specific organic PM species (Delfino et al. 2010; Kioumourtzoglou et al. 2013; Suh et al. 2011), partly because of the complexities in organics sampling and lack of available routine measurements.

For [PM.sub.2.5] components that are measured routinely, a considerable limitation for many studies has been insufficient temporal resolution of PM component data. Routine measurements made by local and federal monitoring programs are generally available only every 3 or 6 days, which limits their usefulness for studies of associations between health outcomes and daily variations in pollutant concentrations. One approach to using these data has been hierarchical analyses that seek to determine whether associations with [PM.sub.2.5] vary by average [PM.sub.2.5] composition across geographic areas (Bell et al. 2009; Franklin et al. 2008; Zanobetti et al. 2009). Although these studies have provided important insight into possible composition-related effects of [PM.sub.2.5], they have not been able to identify specific components as being associated with adverse health on a day-to-day basis (Ito et al. 2011). Recent studies have also applied the non-daily data directly as predictors in epidemiologic analyses, but the non-daily data lead to reduced power and limited ability to assess lag structures (Ito et al. 2011; Levy et al. 2012; Peng et al. 2009), which may be an important consideration depending on the specific outcomes and components of interest (Kim et al. 2012).

A growing number of time-series studies use daily PM component data from special monitoring campaigns, though few have published epidemiologic findings on a broad range of particle components (Mostofsky et al. 2012; Ostro et al. 2009). Here, we conducted a time-series study of [PM.sub.2.5] and cardiorespiratory emergency department (ED) visits in the St. Louis, Missouri-Illinois Sarnat et al.

(MO-IL) metropolitan area. For this project we used 2 years of daily [PM.sub.2.5] and [PM.sub.2.5] component measurements (including ions, carbon, particle-phase organic compounds, and elements) made at the St. Louis-Midwest Supersite. The St. Louis-Midwest Supersite was a monitoring site of the U.S. EPA Supersites ambient air monitoring research program, at which intensive measurements of fine particles were made during 2001-2003 for the broad goal of addressing scientific uncertainties associated with [PM.sub.2.5].

Methods

ED visit data. Computerized billing records were obtained from the Missouri Hospital Association (MHA) for emergency department visits to 36 of 43 acute care hospitals in the eight Missouri counties and eight Illinois counties of the St. …

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