Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Environ Health Perspect. 2008 Dec;116(12):1614-9. doi: 10.1289/ehp.11449. Epub 2008 Aug 12.

Mortality in the Medicare population and chronic exposure to fine particulate air pollution in urban centers (2000-2005).

Author information

  • 1Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Abstract

BACKGROUND:

Prospective cohort studies constitute the major source of evidence about the mortality effects of chronic exposure to particulate air pollution. Additional studies are needed to provide evidence on the health effects of chronic exposure to particulate matter < or = 2.5 microm in aerodynamic diameter (PM(2.5)) because few studies have been carried out and the cohorts have not been representative.

OBJECTIVES:

This study was designed to estimate the relative risk of death associated with long-term exposure to PM(2.5) by region and age groups in a U.S. population of elderly, for the period 2000-2005.

METHODS:

By linking PM(2.5) monitoring data to the Medicare billing claims by ZIP code of residence of the enrollees, we have developed a new retrospective cohort study, the Medicare Cohort Air Pollution Study. The study population comprises 13.2 million participants living in 4,568 ZIP codes having centroids within 6 miles of a PM(2.5) monitor. We estimated relative risks adjusted by socioeconomic status and smoking by fitting log-linear regression models.

RESULTS:

In the eastern and central regions, a 10-microg/m(3) increase in 6-year average of PM(2.5) is associated with 6.8% [95% confidence interval (CI), 4.9-8.7%] and 13.2% (95% CI, 9.5-16.9) increases in mortality, respectively. We found no evidence of an association in the western region or for persons > or = 85 years of age.

CONCLUSIONS:

We established a cohort of Medicare participants for investigating air pollution and mortality on longer-term time frames. Chronic exposure to PM(2.5) was associated with mortality in the eastern and central regions, but not in the western United States.

KEYWORDS:

Medicare; ecologic bias; fine particulate matter (PM2.5); heterogeneity; log-linear models; mortality; prospective studies

PMID:
19079710
[PubMed - indexed for MEDLINE]
PMCID:
PMC2599753
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for National Institute of Environmental Health Sciences Icon for PubMed Central
    Loading ...
    Write to the Help Desk