Environment International最新文献

{"title":"Corrigendum to “Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas” [Environ. Int. 178 (2023) 108005]","authors":"Stephanie E. Cleland, William Steinhardt, Lucas M. Neas, J.Jason West, Ana G. Rappold","doi":"10.1016/j.envint.2025.109613","DOIUrl":"https://doi.org/10.1016/j.envint.2025.109613","url":null,"abstract":"No Abstract","PeriodicalId":308,"journal":{"name":"Environment International","volume":"21 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of neonatal diseases attributable to fine particulate matter air pollution, 1990–2050","authors":"Zhe Xu ,&nbsp;Dun Li ,&nbsp;Qiao Liu ,&nbsp;Sheng Li ,&nbsp;Yujian Li ,&nbsp;Shu Li ,&nbsp;Yuhong Bian ,&nbsp;Xuan Kan ,&nbsp;Yaogang Wang ,&nbsp;Jue Liu","doi":"10.1016/j.envint.2025.109638","DOIUrl":"10.1016/j.envint.2025.109638","url":null,"abstract":"<div><div>Fine particulate matter (PM_2.5) air pollution constitutes a significant hazard to the well-being and survival of children everywhere, posing particularly dire risks to neonates. However, the neonatal disease burden attributable to PM_2.5 pollution remains unclear worldwide. Data on neonatal diseases attributable to PM_2.5 pollution were obtained and collected from the Global Burden of Disease Study (GBD) 2021. The main outcome was the age-standardized disability-adjusted life-years (DALYs) rate (ASDR) and age-standardized mortality rate (ASMR) per 100 000 population of neonatal diseases caused by PM_2.5 pollution. These metrics were stratified by sex, region, country, and disease. The correlations, trends, and projections of the burden were also analyzed. Globally, there were approximately 497.0 thousand deaths and 44737.3 thousand DALYs from neonatal diseases caused by PM_2.5 pollution in 2021. From 1990 to 2021, the overall ASDR (1120.4 to 723.1) and ASMR (12.5 to 8.0) showed a downward trend. However, the ASDR of neonatal diseases attributable to PM_2.5 pollution was high in Sub-Saharan Africa (1717.1 to 1235.8) and South Asia (2010.4 to 1148.1), especially regarding household PM_2.5 pollution. The higher ASDR attributable to PM_2.5 pollution was observed in neonatal encephalopathy due to birth asphyxia and trauma and neonatal preterm birth. By 2050, the ASDR of neonatal disease impacts from household PM_2.5 pollution remain persistently high. Neonatal disease burden attributable to PM_2.5 pollution remains a crucial health issue in children. Targeted strategies to improve PM_2.5 air quality and neonatal disease burden are essential.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109638"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant species richness, green spaces, and preterm birth risk in urban areas","authors":"Mengyi Li ,&nbsp;Qiping Fan ,&nbsp;Yi Sun ,&nbsp;Tarik Benmarhnia ,&nbsp;Jiu-Chiuan Chen ,&nbsp;Anqi Jiao ,&nbsp;John Molitor ,&nbsp;David A. Sacks ,&nbsp;Jeff M. Slezak ,&nbsp;Vicki Y. Chiu ,&nbsp;Chantal C. Avila ,&nbsp;Darios Getahun ,&nbsp;Jun Wu","doi":"10.1016/j.envint.2025.109644","DOIUrl":"10.1016/j.envint.2025.109644","url":null,"abstract":"<div><h3>Background</h3><div>Growing evidence suggests that urban biodiversity may influence human health, though this relationship remains incompletely understood. While green spaces have shown beneficial effects on birth outcomes, the specific role of plant species richness has not been investigated in relation to preterm birth (PTB, &lt;37 weeks’ gestation).</div></div><div><h3>Methods</h3><div>Using Kaiser Permanente Southern California electronic health records (2015–2021), we analyzed 232,452 births to examine associations between plant species richness and PTB. Plant species richness was assessed at the maternal neighborhood level, defined using circular buffers of 1.5 km around maternal residences.</div></div><div><h3>Results</h3><div>We found that increased plant species richness was associated with decreased PTB risk (adjusted odds ratio per interquartile range: 0.959, 95 % CI: 0.941, 0.977). The observed association persisted after further adjustment for multiple green space indicators. The proportions of mediation effects attributable to mean temperature during pregnancy ranged from 7.0 % to 7.8 % across plant species diversity indicators. In the subgroup analysis, plant species diversity demonstrated significantly stronger protective associations against PTB among mothers exposed to higher levels of Ozone, high ambient temperatures, and those gave birth during the pandemic period. Conversely, protective associations were more pronounced among mothers with lower NO₂ exposure during pregnancy. Notably, the significant relationship between plant species richness and reduced PTB persisted in pandemic-period analyses after adjusting for COVID-19 infection during pregnancy.</div></div><div><h3>Conclusions</h3><div>Our findings highlight a complex interplay of sociodemographic and environmental factors influencing PTB risks and underscore the critical need for public health interventions that consider the unique attributes of urban green space.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109644"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal and early childhood exposure to biothermal stress and developmental vulnerability at school entry in Western Australia: a population-based cohort study","authors":"Kendalem Asmare Atalell ,&nbsp;Gavin Pereira ,&nbsp;Bereket Duko ,&nbsp;Sylvester Dodzi Nyadanu ,&nbsp;Melissa O’Donnell ,&nbsp;Gizachew A Tessema","doi":"10.1016/j.envint.2025.109642","DOIUrl":"10.1016/j.envint.2025.109642","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Rising global temperatures, including in Australia, increase biothermal stress. However, the impact of prenatal and childhood exposure to extreme biothermal stress, measured by the Universal Thermal Climate Index (UTCI), on early childhood developmental vulnerability remains unclear. This study aimed to examine the association between prenatal and early childhood exposure to biothermal stress and early childhood developmental vulnerability at school entry in Western Australia.</div></div><div><h3>Methods</h3><div>A population-based retrospective cohort study of 59,771 children from the 2009–2015 Australian Early Development Census (AEDC) was conducted. UTCI was spatiotemporally linked to maternal residential addresses at the time of birth at the Statistical Area 1 (SA1) level. The average UTCI exposure from conception to AEDC assessment was calculated for each child, with separate analyses for prenatal (conception to birth) and postnatal (birth to AEDC assessment) exposure. Mixed-effect logistic regression models were used to examine the association between childhood developmental vulnerability and biothermal stress.</div></div><div><h3>Result</h3><div>The mean UTCI exposure from conception to AEDC assessment was 14.4 ± 2.5 °C. After adjusting for potential confounders, children exposed to heat stress during this period had 29 % higher odds of DV1 (developmentally vulnerable in one or more AEDC domain(s)) than those exposed to optimal thermal conditions (9–26 °C) (OR: 1.29; 95 % CI: 1.05–1.58). Prenatal exposure to heat stress was associated with 34 % higher odds of DV1 (OR: 1.34; 95 % CI: 1.10–1.65).</div></div><div><h3>Conclusion</h3><div>Exposure to heat stress from conception to the AEDC assessment date increases developmental vulnerability, with the strongest effect observed during the prenatal period. Policymakers might integrate heat exposure considerations into maternal and child health strategies to mitigate risks for vulnerable populations.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109642"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the complexity of exposure to multiclass organic pollutants in respirable size-resolved particles and implications for oxidative potential","authors":"Ying-Jie Zhang,&nbsp;Ting-Ting Xu,&nbsp;Yu-Ling Luan,&nbsp;Hui-Min Shen,&nbsp;Ying Guo","doi":"10.1016/j.envint.2025.109646","DOIUrl":"10.1016/j.envint.2025.109646","url":null,"abstract":"<div><div>Chronic exposure to inhalable atmospheric particulate matter is linked to millions of annual premature deaths globally. Yet the sources and factors driving oxidative potential (OP) remain poorly understood, especially regarding the coexistence of multi-organic pollutants. This longitudinal study examined the size-distribution, respiratory deposition efficiency and daily exposure of 41 chemicals covering polycyclic aromatic hydrocarbons (PAHs), brominated flame retardants (BFRs), and phthalates (PAEs), as well as the dithiothreitol-based OP in size-fractioned PM₁₀ from distinct waste recycling plants in Guangzhou, South China. From September to December 2020, five parallel samples were successively collected within each of the four plants using an eight-stage cascade sampler. The particle size-dependent correlations were explored between co-existing pollutants and acellular OP, with a weighted quantile sum regression model to rank the relative contribution ratios. The ∑₈PAE levels in PM₁₀ were 100 and 1000 times higher than those of ∑₁₆PAH and ∑₁₇BFR respectively, aligning with the exposure outcomes of dermal contact and inhalation pathways. Compounds in the coarse fractions of PM_9.0–10 primarily deposited in the upper respiratory tract, while 37%–73% in pulmonary alveoli were attributed to finer PM_2.1. The high-molecular-weight PAHs and BFRs in PM_9.0–10 were more effective in enhancing OP generation than PAEs, with benzo[g,h,i]perylene identified as the most potent oxidizing agent with the highest weight (22%). The findings underscore that elevated pollution burden doses may not necessarily represent severe oxidative toxicity, and the targeted prevention strategies are warranted to mitigate oxidative toxicity from respirable particle.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109646"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure-response functions of the correlated environmental exposures green space, noise, and air pollution for quantifying mortality burden in health impact assessment","authors":"Xuan Chen ,&nbsp;Ulrike Gehring ,&nbsp;Georgia M.C. Dyer ,&nbsp;Kees de Hoogh ,&nbsp;Sasha Khomenko ,&nbsp;Haneen Khreis ,&nbsp;Natalie Mueller ,&nbsp;Roel Vermeulen ,&nbsp;Harry Williams ,&nbsp;Belen Zapata-Diomedi ,&nbsp;Mark Nieuwenhuijsen ,&nbsp;Gerard Hoek","doi":"10.1016/j.envint.2025.109645","DOIUrl":"10.1016/j.envint.2025.109645","url":null,"abstract":"<div><h3>Objective</h3><div>Environmental health impact assessments (HIA)<!--> <!-->on green space, air pollution (fine particulate matter (PM_2.5) or nitrogen dioxide (NO₂)), and noise use exposure–response functions (ERF) based on single-exposure models from epidemiological studies, not accounting for potential confounding by other commonly correlated exposures. We assessed differences in ERFs between single- and multi-exposure models for calculation of joint health impacts in HIA.</div></div><div><h3>Methods</h3><div>We systematically searched cohort studies that reported both single- and multi-exposure models for associations of long-term exposure to any combination of the following exposures green space, PM_2.5, NO₂, and noise, with all-cause mortality. For each exposure, pooled hazard ratios (HRs) were calculated by meta-analyses and compared between single- and two-exposure models. The joint effects of two exposures in each exposure pair were expressed as joint HRs calculated by multiplying the individual HRs. Coefficient differences were calculated, and population attributable fractions (PAF) were used to estimate joint health impacts.</div></div><div><h3>Results</h3><div>Eleven studies were identified, examining associations between multiple exposures and mortality in the general population. The studies show substantial variability in exposure levels and correlations between exposures. For most exposure pairs, adjusting for a second exposure resulted in moderately attenuated HRs compared to single-exposure models. The mortality PAFs estimated from joint single-exposure model HRs were higher than those from two-exposure models, indicating an overestimation of mortality burden when not accounting for other co-exposures. For example, when adjusted for green space or noise, the mortality HRs for PM_2.5 were attenuated from 1.071 to 1.061 and 1.072 to 1.055, respectively. As for PAFs, for the green space-PM_2.5 pair, the single-exposure model PAF (0.090) was 18.4% higher than the two-exposure model (0.076). For all exposure pairs, the joint PAFs of two-exposure models were higher than the PAFs from the single-exposure models for each exposure individually.</div></div><div><h3>Conclusion</h3><div>The pooled coefficient differences from this study can be used to adjust single-exposure ERFs from meta-analyses and allow the calculation of combined impacts from multiple environmental exposures, making HIA estimates more robust and realistic.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109645"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifying effects of vitamin D on associations between per- and polyfluoroalkyl substances exposure and risk of gestational diabetes mellitus: A prospective cohort study in Beijing, China","authors":"Feng Han ,&nbsp;Ziwei Pei ,&nbsp;Bing Lyu ,&nbsp;Xin Zhang ,&nbsp;Jian Zhang ,&nbsp;Jiaying Liu","doi":"10.1016/j.envint.2025.109641","DOIUrl":"10.1016/j.envint.2025.109641","url":null,"abstract":"<div><div>Epidemiology studies suggested that exposure to Per- and Polyfluoroalkyl Substances (PFAS) might elevate the incidence of Gestational Diabetes Mellitus (GDM), but no study considered the modifying roles of vitamin D, an important nutrient related to GDM development. Thus, this study evaluated the modifying effects of maternal vitamin D on correlations of PFAS exposure with GDM by conducting a cohort study in Beijing, China. We recruited 111 pregnant women who had either one or more high risk factors for GDM in Beijing, China, in 2022. Blood samples collected from pregnant women in 11–13 gestational weeks were analyzed to detect 19 PFAS and 25-hydroxy vitamin D. GDM was confirmed via the Oral Glucose Tolerance Test (OGTT). All subjects were classed as possessing sufficient, insufficient, or deficient vitamin D concentrations. Vitamin D deficiency status was observed to be a significant modifier for associations between GDM risk and PFAS exposure, as well as continuous glucose concentrations in an OGTT (interaction <em>p</em>-value &lt; 0.05). For women with vitamin D deficiency, exposure to five long-chain perfluoroalkyl carboxylates significantly elevated the GDM risk (<em>p</em> &lt; 0.05), and the overall estimated risk ratio for GDM associated with 1 ng/mL increases in PFAS ranged from 3.750 to 8.097. The results suggested that adequate supplementation of vitamin D during early pregnancy could prevent the elevated risk of GDM caused by PFAS exposure.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109641"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the 3+30+300 urban green space rule and mental health, physical activity, and overweight: A population-based study in the Netherlands","authors":"Marco Helbich ,&nbsp;Matthew H.E.M. Browning ,&nbsp;Dirk Voets ,&nbsp;Payam Dadvand","doi":"10.1016/j.envint.2025.109643","DOIUrl":"10.1016/j.envint.2025.109643","url":null,"abstract":"<div><h3>Background</h3><div>The 3+30+300 guideline aims to establish a standard for healthier cities to enhance population health through the provision of trees and green space; however, little empirical evidence to support its effectiveness is available.</div></div><div><h3>Objectives</h3><div>We aimed to 1) evaluate the adherence to the 3+30+300 urban green space rule in the Netherlands; 2) examine the associations between the 3+30+300 rule (and its components) and adults’ health and behavioral outcomes; and 3) assess possible effect modifications by age, sex, income, and urbanicity.</div></div><div><h3>Methods</h3><div>We used population-based health survey data for 2022 from the Netherlands. Adults’ general health, psychological complaints, anxiety and depression symptoms, psychological resilience, physical activity, and overweight were assessed alongside the 3+30+300 rule at the residential addresses. Covariate-adjusted mixed effects logistic regressions estimated the associations of health and behavioral outcomes with the 3+30+300 components—individually and jointly. Subgroup analyses based on age, sex, income, and urbanicity were also conducted.</div></div><div><h3>Results</h3><div>Of the 180,949 respondents, 16.4 % met the 3+30+300 rule. Respondents meeting the 3+30+300 rule were significantly less likely to be overweight and were significantly more likely to be physically active than those not meeting the rule. Neither meeting the 3+30+300 rule nor its components showed any association with other health or behavioral outcomes. We found no notable effect modification by age, sex, income, and urbanicity.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that meeting the 3+30+300 green space rule may promote certain health benefits, particularly by supporting better weight management and higher physical activity levels, though its role in mental health remains inconclusive.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109643"},"PeriodicalIF":10.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a highly sensitive reporter gene cell line for detecting estrogenic activity (the ER Isjaki assay)","authors":"Aline Colonnello Montero,&nbsp;Geeta Mandava,&nbsp;Agneta Oskarsson,&nbsp;Johan Lundqvist","doi":"10.1016/j.envint.2025.109635","DOIUrl":"10.1016/j.envint.2025.109635","url":null,"abstract":"<div><div>Monitoring of estrogens in water sources faces significant challenges, as proposed changes in the European Union regulation for environmental protection of water bodies, compromise the ability of conventional analytical methods to detect low concentrations of estrogens. The proposed changes involve the decrease of the environmental quality standards for 17β-estradiol, estrone and 17α-ethinyl estradiol in surface waters and the obligation to monitor estrogenic substances in water bodies, using effect-based methods. In this study, the optimal experimental conditions for developing a novel and highly sensitive reporter gene assay were established. For this purpose, optimization of transfection plasmid concentration, exposure time and basement membrane matrix effect as well as assessment of assay reproducibility and relative effect potency of natural estrogens and estrogenic substances were conducted. With the optimal experimental conditions set as 5 ng per well in 96-well uncoated plates for plasmid transfection and 24 h exposure to treatments, the assay yielded an average sensitivity, measured as effect level 20 % for 17β-estradiol, estrone and 17α-ethinyl estradiol of 0.29, 1.36 and 0.02 pM, respectively. The assay showed a reproducibility variation of approximately 20 % and was able to differentiate the relative effect potency between 17α-ethinyl estradiol and 17β-estradiol with the capacity of detecting 17α-ethinyl estradiol with a high relative effect potency. Moreover, this assay is approximately 10–100 times more sensitive compared to the current state-of-the-art <em>in vitro</em> assays used to measure estrogenicity, indicating that the assay can be used to detect 17β-estradiol, estrone and 17α-ethinyl estradiol at the low levels needed to meet regulatory standards.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109635"},"PeriodicalIF":10.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intermediate and long-term exposure to ambient air pollution and temperature on hospital admissions with second cardiovascular events among medicare beneficiaries","authors":"Mahdieh Danesh Yazdi ,&nbsp;Yaguang Wei ,&nbsp;Qian Di ,&nbsp;Weeberb J. Requia ,&nbsp;Adjani A. Peralta ,&nbsp;Francesca Dominici ,&nbsp;Joel D. Schwartz","doi":"10.1016/j.envint.2025.109617","DOIUrl":"10.1016/j.envint.2025.109617","url":null,"abstract":"<div><h3>Background</h3><div>Air pollution has been linked to cardiovascular diseases (CVDs). In this study, we assess whether exposure to air pollutants and ambient temperature is associated with repeated admissions with adverse cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>We used data from Medicare beneficiaries between 2000 and 2016 to look at the effects of intermediate and long-term exposure to ambient PM_2.5, NO₂, O₃, and temperature on second admissions with myocardial infarction (MI) and ischemic stroke. We derived exposure levels from high-resolution spatiotemporal models. We adjusted for demographic, socioeconomic, and access-to-care characteristics. Cox proportional hazards models were used to assess these relationships. We further looked at the effects of exposure at lower air pollution concentrations defined as PM_2.5 &lt; 9 µg/m³, NO₂ &lt; 25 ppb, and O₃ &lt; 50 ppb.</div></div><div><h3>Results</h3><div>PM_2.5 and NO₂ increased the hazard of second admissions with both MI and stroke. For PM_2.5, the effects were more pronounced for longer exposure time windows. Each µg/m³ increase in one-year PM_2.5 levels before the first admission increased the hazard of a second admission with MI by 1.1% (95% CI: 1.0%-1.2%) and stroke by 0.9% (95% CI: 0.8%-1.1%). O₃ exhibited a slight protective effect for both outcomes. Higher temperatures were associated with a higher hazard of second admissions with stroke. These results persisted at lower concentrations.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that exposures to PM_2.5 and NO₂ are associated with increased rates of second admissions with MIs and strokes. Higher temperatures were also further associated with an increase in the rate of second admissions with stroke.</div></div>","PeriodicalId":308,"journal":{"name":"Environment International","volume":"202 ","pages":"Article 109617"},"PeriodicalIF":10.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}