Mahdieh Danesh Yazdi , Yaguang Wei , Qian Di , Weeberb J. Requia , Adjani A. Peralta , Francesca Dominici , Joel D. Schwartz
{"title":"中期和长期暴露于环境空气污染和温度对医疗保险受益人中第二次心血管事件住院的影响","authors":"Mahdieh Danesh Yazdi , Yaguang Wei , Qian Di , Weeberb J. Requia , Adjani A. Peralta , Francesca Dominici , Joel D. Schwartz","doi":"10.1016/j.envint.2025.109617","DOIUrl":null,"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<sub>2.5</sub>, NO<sub>2</sub>, O<sub>3</sub>, 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<sub>2.5</sub> < 9 µg/m<sup>3</sup>, NO<sub>2</sub> < 25 ppb, and O<sub>3</sub> < 50 ppb.</div></div><div><h3>Results</h3><div>PM<sub>2.5</sub> and NO<sub>2</sub> increased the hazard of second admissions with both MI and stroke. For PM<sub>2.5</sub>, the effects were more pronounced for longer exposure time windows. Each µg/m<sup>3</sup> increase in one-year PM<sub>2.5</sub> 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%). O<sub>3</sub> 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<sub>2.5</sub> and NO<sub>2</sub> 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":10.3000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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 , Yaguang Wei , Qian Di , Weeberb J. Requia , Adjani A. Peralta , Francesca Dominici , Joel D. Schwartz\",\"doi\":\"10.1016/j.envint.2025.109617\",\"DOIUrl\":null,\"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<sub>2.5</sub>, NO<sub>2</sub>, O<sub>3</sub>, 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<sub>2.5</sub> < 9 µg/m<sup>3</sup>, NO<sub>2</sub> < 25 ppb, and O<sub>3</sub> < 50 ppb.</div></div><div><h3>Results</h3><div>PM<sub>2.5</sub> and NO<sub>2</sub> increased the hazard of second admissions with both MI and stroke. For PM<sub>2.5</sub>, the effects were more pronounced for longer exposure time windows. Each µg/m<sup>3</sup> increase in one-year PM<sub>2.5</sub> 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%). O<sub>3</sub> 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<sub>2.5</sub> and NO<sub>2</sub> are associated with increased rates of second admissions with MIs and strokes. 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Effects of intermediate and long-term exposure to ambient air pollution and temperature on hospital admissions with second cardiovascular events among medicare beneficiaries
Background
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.
Methods
We used data from Medicare beneficiaries between 2000 and 2016 to look at the effects of intermediate and long-term exposure to ambient PM2.5, 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 PM2.5 < 9 µg/m3, NO2 < 25 ppb, and O3 < 50 ppb.
Results
PM2.5 and NO2 increased the hazard of second admissions with both MI and stroke. For PM2.5, the effects were more pronounced for longer exposure time windows. Each µg/m3 increase in one-year PM2.5 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.
Conclusion
Our study demonstrates that exposures to PM2.5 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.
期刊介绍:
Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review.
It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.