medRxiv : the preprint server for health sciences · 2025
Cardiopulmonary hospitalization risks from wildfire and non-wildfire PM2.5 in 20 US states.
СтатьяПрепринтНазвание и аннотация: Перевод в очереди
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Zhang Min, Castro Edgar, Qiu Minghao, Yazdi Mahdieh Danesh, Li Boyuan, Wright Rosalind J, Schwartz Joel D, Wright Robert O, Wei Yaguang
Аннотация
IMPORTANCE: Given the increasing wildfire activity in the US, assessment of the health impacts of wildfire-specific fine particulate matter (PM2.5), a growing source of surface air pollution, and its relative toxicity compared to non-wildfire PM2.5 is needed to support mitigation strategies.
OBJECTIVE: To investigate associations of long-term exposure of wildfire-specific and non-wildfire PM2.5 with cardiopulmonary hospitalization risks.
DESIGN SETTING AND PARTICIPANTS: We obtained over 89 million cardiopulmonary hospitalizations for residents across 20 US states from 2006 to 2019 from the State Inpatient Databases. We assigned estimated 2-year average concentrations of wildfire-specific and non-wildfire PM2.5 to each hospitalization based on residential ZIP codes to characterize exposure levels. We used a self-controlled design, which is robust to unmeasured confounding, to assess the associations.
EXPOSURES: 2-year moving average exposures to wildfire-specific and non-wildfire PM2.5 from the year of hospitalization to the prior year.
MAIN OUTCOMES AND MEASURES: The hospitalizations for cardiovascular (ischemic heart disease, cerebrovascular disease, heart failure, arrhythmia, other cardiovascular diseases) and pulmonary diseases (acute respiratory infections, pneumonia, chronic obstructive pulmonary disease [COPD], asthma, other respiratory diseases) were identified based on the first 3 diagnosis codes at discharge.
RESULTS: Wildfire-specific PM2.5 had stronger effects than non-wildfire PM2.5. Specifically, each 1-μg/m3 increase in 2-year wildfire-specific PM2.5 was significantly associated with increased hospitalization risks for all cardiopulmonary diseases, with relative risk ranging from 1.100 (95% CI: 1.091, 1.108) for heart failure to 1.160 (95% CI: 1.142, 1.178) for asthma. In comparison, a 1 μg/m3 increase in non-wildfire PM2.5 was associated with increased hospitalization risks for all cardiopulmonary diseases, but with relative risks ranging from 1.047 (95% CI: 1.042, 1.051) for COPD to 1.085 (95% CI: 1.082, 1.088) for hypertension. Stronger effects of both wildfire-specific and non-wildfire PM2.5 were observed among minorities, individuals with obesity or diabetes, and those living in metropolitan areas, those with fewer years of education, and more deprived communities.
CONCLUSIONS: Long-term exposure to wildfire-specific PM2.5 poses a greater risk of cardiopulmonary hospitalization than PM2.5 from non-wildfire sources. Greater effort should be placed on wildfire management, with particular focus on strategies to reduce smoke in addition to traditional air quality control strategies.
OBJECTIVE: To investigate associations of long-term exposure of wildfire-specific and non-wildfire PM2.5 with cardiopulmonary hospitalization risks.
DESIGN SETTING AND PARTICIPANTS: We obtained over 89 million cardiopulmonary hospitalizations for residents across 20 US states from 2006 to 2019 from the State Inpatient Databases. We assigned estimated 2-year average concentrations of wildfire-specific and non-wildfire PM2.5 to each hospitalization based on residential ZIP codes to characterize exposure levels. We used a self-controlled design, which is robust to unmeasured confounding, to assess the associations.
EXPOSURES: 2-year moving average exposures to wildfire-specific and non-wildfire PM2.5 from the year of hospitalization to the prior year.
MAIN OUTCOMES AND MEASURES: The hospitalizations for cardiovascular (ischemic heart disease, cerebrovascular disease, heart failure, arrhythmia, other cardiovascular diseases) and pulmonary diseases (acute respiratory infections, pneumonia, chronic obstructive pulmonary disease [COPD], asthma, other respiratory diseases) were identified based on the first 3 diagnosis codes at discharge.
RESULTS: Wildfire-specific PM2.5 had stronger effects than non-wildfire PM2.5. Specifically, each 1-μg/m3 increase in 2-year wildfire-specific PM2.5 was significantly associated with increased hospitalization risks for all cardiopulmonary diseases, with relative risk ranging from 1.100 (95% CI: 1.091, 1.108) for heart failure to 1.160 (95% CI: 1.142, 1.178) for asthma. In comparison, a 1 μg/m3 increase in non-wildfire PM2.5 was associated with increased hospitalization risks for all cardiopulmonary diseases, but with relative risks ranging from 1.047 (95% CI: 1.042, 1.051) for COPD to 1.085 (95% CI: 1.082, 1.088) for hypertension. Stronger effects of both wildfire-specific and non-wildfire PM2.5 were observed among minorities, individuals with obesity or diabetes, and those living in metropolitan areas, those with fewer years of education, and more deprived communities.
CONCLUSIONS: Long-term exposure to wildfire-specific PM2.5 poses a greater risk of cardiopulmonary hospitalization than PM2.5 from non-wildfire sources. Greater effort should be placed on wildfire management, with particular focus on strategies to reduce smoke in addition to traditional air quality control strategies.