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Environ Res. 2018 Feb;161:364-369. doi: 10.1016/j.envres.2017.11.025. Epub 2017 Dec 1.

Fine particulate matters: The impact of air quality standards on cardiovascular mortality.

Author information

1
Oak Ridge Institute for Science and Education at the United States Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, NC, United States.
2
United States Environmental Protection Agency, Region 5, Air and Radiation Division, IL, United States.
3
United States Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, NC, United States.
4
United States Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, NC, United States. Electronic address: rappold.ana@epa.gov.

Abstract

BACKGROUND:

In 1997 the U.S. Environmental Protection Agency set the first annual National Ambient Air Quality Standard (NAAQS) for fine particulate matter (PM2.5). Although the weight of scientific evidence has determined that a causal relationship exists between PM2.5 exposures and cardiovascular effects, few studies have concluded whether NAAQS-related reductions in PM2.5 led to improvements in public health.

METHODS:

We examined the change in cardiovascular (CV) mortality rate and the association between change in PM2.5 and change in CV-mortality rate before (2000-2004) and after implementation of the 1997 annual PM2.5 NAAQS (2005-2010) among U.S. counties. We further examined how the association varied with respect to two factors related to NAAQS compliance: attainment status and design values (DV). We used difference-in-differences and linear regression models, adjusted for sociodemographic confounders.

FINDINGS:

Across 619 counties, there were 1.10 (95% CI: 0.37, 1.82) fewer CV-deaths per year per 100,000 people for each 1µg/m3 decrease in PM2.5. Nonattainment counties had a twofold larger reduction in mean annual PM2.5, 2.1µg/m3, compared to attainment counties, 0.97µg/m3. CV-mortality rate decreased by 0.59 (95% CI: -0.54, 1.71) in nonattainment and 1.96 (95% CI: 0.77, 3.15) deaths per 100,000 people for each 1µg/m3 decrease in PM2.5 in attainment counties. When stratifying counties by DV, results were similar: counties with DV greater than 15µg/m3 experienced the greatest decrease in mean annual PM2.5 (2.29µg/m3) but the smallest decrease in CV-mortality rate per unit decrease in PM2.5, 0.73 (95% CI: -0.57, 2.02).

INTERPRETATION:

We report a significant association between the change in PM2.5 and the change in CV-mortality rate before and after the implementation of NAAQS and note that the health benefits per 1µg/m3 decrease in PM2.5 persist at levels below the current national standard.

FUNDING:

US EPA intermural research.

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