Coarse particles and mortality: evidence from a multi-city study in California.

OBJECTIVE: To examine the risk of all-cause and cardiovascular mortality associated with short-term coarse particle exposure in California while addressing issues of exposure misclassification by limiting the study to those residing near a pollution monitor. METHODS: Deaths in 15 California counties from 1999 to 2005 were linked to coarse particulate monitoring data. Case deaths were limited to those residing in a zip code within 20 km of a pollution monitor. We used conditional logistic regression with a case-crossover design to estimate county-specific effects of coarse particles. County estimates were then pooled using random-effects meta-analysis to create overall study estimates. Effects specific to race and educational status were also analysed. RESULTS: We observed an increased excess risk (ER) of both all-cause mortality (ER per 10 microg/m(3) = 0.7%, 95% CI -0.1 to 1.5) and cardiovascular mortality (ER per 10 microg/m(3) = 1.3%, 95% CI 0.1 to 2.5) from a 2-day lag in coarse particles. Greater effects were observed among Hispanics and non-high school graduates. Adjustment for fine particles and decreasing the inclusion buffer to 10 km did not substantively alter the results. CONCLUSIONS: Our study provides further evidence of an association between acute exposure to coarse particles and mortality, and supports the hypothesis that lower socioeconomic status groups may be more susceptible to its effects.

The impact of components of fine particulate matter on cardiovascular mortality in susceptible subpopulations.

BACKGROUND: Several studies have demonstrated associations between daily mortality and ambient particulate matter less than 2.5 microns in diameter (fine particles or PM2.5). Few, however, have examined the relative toxicities of PM2.5 constituents, including elemental carbon and organic carbon (EC and OC, respectively), nitrates and transition metals. There is also little information about whether associations between PM2.5 constituents and mortality are modified by socioeconomic and demographic factors. AIM: To examine associations of daily cardiovascular mortality with PM2.5 and its constituents after stratification by gender, race/ethnicity and education, using data from six California counties during 2000 to 2003. METHODS: The association of daily counts of cardiovascular mortality with PM2.5 components was analysed using time-series regression analyses. Poisson models with natural splines were used to control for time-varying covariates such as season and weather. Separate models were run after stratification by gender, race/ethnicity (White, Hispanic, Black) and education (high school graduation or not). Models were run for each county and results were combined using random effects meta-analysis. RESULTS: Daily counts of cardiovascular mortality were associated with PM2.5 and several of its species including EC, OC, nitrates, sulphates, potassium, copper and iron. For many of these species, there were significantly higher effect estimates among those with lower educational attainment and Hispanic individuals. For example, while essentially no association was observed for individuals who graduated from high school, an interquartile change in several of the components of PM2.5 was associated with a 3-5% increase in daily mortality among non-high school graduates. CONCLUSION: There is evidence that several PM2.5 constituents may represent important contributors to cardiovascular mortality. Many of these constituents are generated by motor vehicles, especially those with diesel engines, and by residential wood combustion. In addition, factors associated with low educational attainment may increase susceptibility to PM2.5 and its components.