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. 2018 Oct 15:639:868-875.
doi: 10.1016/j.scitotenv.2018.05.181. Epub 2018 May 26.

The association between short and long-term exposure to PM2.5 and temperature and hospital admissions in New England and the synergistic effect of the short-term exposures

Maayan Yitshak-Sade  1 , Jennifer F Bobb  2 , Joel D Schwartz  1 , Itai Kloog  3 , Antonella Zanobetti  4
Affiliations

The association between short and long-term exposure to PM2.5 and temperature and hospital admissions in New England and the synergistic effect of the short-term exposures

Maayan Yitshak-Sade et al. Sci Total Environ. .

Abstract

Background: Particulate matter < 2.5 μm in diameter (PM2.5) and heat are strong predictors of morbidity, yet few studies have examined the effects of long-term exposures on non-fatal events, or assessed the short and long-term effect on health simultaneously.

Objective: We jointly investigated the association of short and long-term exposures to PM2.5 and temperature with hospital admissions, and explored the modification of the associations with the short-term exposures by one another and by temperature variability.

Methods: Daily ZIP code counts of respiratory, cardiac and stroke admissions of adults ≥65 (N = 2,015,660) were constructed across New-England (2001-2011). Daily PM2.5 and temperature exposure estimates were obtained from satellite-based spatio-temporally resolved models. For each admission cause, a Poisson regression was fit on short and long-term exposures, with a random intercept for ZIP code. Modifications of the short-term effects were tested by adding interaction terms with temperature, PM2.5 and temperature variability.

Results: Associations between short and long-term exposures were observed for all of the outcomes, with stronger effects of long-term exposures to PM2.5. For respiratory admissions, the short-term PM2.5 effect (percent increase per IQR) was larger on warmer days (1.12% versus -0.53%) and in months of higher temperature variability (1.63% versus -0.45%). The short-term temperature effect was higher in months of higher temperature variability as well. For cardiac admissions, the PM2.5 effect was larger on colder days (0.56% versus -0.30%) and in months of higher temperature variability (0.99% versus -0.56%).

Conclusions: We observed synergistic effects of short-term exposures to PM2.5, temperature and temperature variability. Long-term exposures to PM2.5 were associated with larger effects compared to short-term exposures.

Keywords: Cardiac; Hospitalizations; Particulate matter; Respiratory; Temperature.

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Conflict of interest statement

The authors have no competing financial interests to declare

Figures

Figure 1
Figure 1. The effect of short-term temperature across the range of short-term PM2.5 and monthly standard deviation (SD) of temperature
Results are presented as percent change and 95% Confidence Intervals (CI) for an IQR increase in temperature at the 10th and 90th percentiles of the distribution of short-term exposure to PM2.5and monthly standard deviation of temperature.
Figure 2
Figure 2. The effect of short-term PM2.5 across the range of short-term temperature and monthly standard deviation (SD) of temperature
Results are presented as percent change and 95% Confidence Intervals (CI) for an IQR increase in short-term exposure to PM2.5 at the 10th and 90th percentiles of the distribution of short-term exposure to temperature and monthly standard deviation of temperature.
Figure 3
Figure 3
See this image and copyright information in PMC

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