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. 2016 Apr;124(4):484-90.
doi: 10.1289/ehp.1509676. Epub 2015 Sep 15.

Ambient Particulate Matter Air Pollution Exposure and Mortality in the NIH-AARP Diet and Health Cohort

George D Thurston  1 , Jiyoung Ahn, Kevin R Cromar, Yongzhao Shao, Harmony R Reynolds, Michael Jerrett, Chris C Lim, Ryan Shanley, Yikyung Park, Richard B Hayes
Affiliations

Ambient Particulate Matter Air Pollution Exposure and Mortality in the NIH-AARP Diet and Health Cohort

George D Thurston et al. Environ Health Perspect. 2016 Apr.

Abstract

Background: Outdoor fine particulate matter (≤ 2.5 μm; PM2.5) has been identified as a global health threat, but the number of large U.S. prospective cohort studies with individual participant data remains limited, especially at lower recent exposures.

Objectives: We aimed to test the relationship between long-term exposure PM2.5 and death risk from all nonaccidental causes, cardiovascular (CVD), and respiratory diseases in 517,041 men and women enrolled in the National Institutes of Health-AARP cohort.

Methods: Individual participant data were linked with residence PM2.5 exposure estimates across the continental United States for a 2000-2009 follow-up period when matching census tract-level PM2.5 exposure data were available. Participants enrolled ranged from 50 to 71 years of age, residing in six U.S. states and two cities. Cox proportional hazard models yielded hazard ratio (HR) estimates per 10 μg/m3 of PM2.5 exposure.

Results: PM2.5 exposure was significantly associated with total mortality (HR = 1.03; 95% CI: 1.00, 1.05) and CVD mortality (HR = 1.10; 95% CI: 1.05, 1.15), but the association with respiratory mortality was not statistically significant (HR = 1.05; 95% CI: 0.98, 1.13). A significant association was found with respiratory mortality only among never smokers (HR = 1.27; 95% CI: 1.03, 1.56). Associations with 10-μg/m3 PM2.5 exposures in yearly participant residential annual mean, or in metropolitan area-wide mean, were consistent with baseline exposure model results. Associations with PM2.5 were similar when adjusted for ozone exposures. Analyses of California residents alone also yielded statistically significant PM2.5 mortality HRs for total and CVD mortality.

Conclusions: Long-term exposure to PM2.5 air pollution was associated with an increased risk of total and CVD mortality, providing an independent test of the PM2.5-mortality relationship in a new large U.S. prospective cohort experiencing lower post-2000 PM2.5 exposure levels.

Citation: Thurston GD, Ahn J, Cromar KR, Shao Y, Reynolds HR, Jerrett M, Lim CC, Shanley R, Park Y, Hayes RB. 2016. Ambient particulate matter air pollution exposure and mortality in the NIH-AARP Diet and Health cohort. Environ Health Perspect 124:484-490; http://dx.doi.org/10.1289/ehp.1509676.

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Conflict of interest statement

G.D.T. has provided expert witness testimony on the human health effects of air pollution before the U.S. Congress, in the U.S. EPA public hearings, and in legal cases. The other authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Continental U.S. map of NIH-AARP study participants’ census tracts.
Figure 2
Figure 2
Concentration–response curves (solid lines) and 95% CIs (dashed lines) based on natural spline models with 4 df, standard Cox models stratified by age and sex, adjusted for all individual-level covariates (race, education, marital status, BMI, alcohol consumption, and smoking history) and contextual covariates [median income ($), and percent high school or less] for (A) all nonaccidental causes and (B) cardiovascular disease. The tick marks on the x-axis identify the distribution of observations according to PM2.5 concentrations.
Figure 3
Figure 3
Comparison of NIH-AARP cohort vs. published ACS cohort all-cause and by-cause mortality hazard ratios per 10 μg/m3 PM2.5, with 95% CIs, for the state of California (CA) and nationwide (US) (Jerrett et al. 2013; Krewski et al. 2009).
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