Short-term PM2.5 raises deaths and Parkinson’s admissions
Two-day average PM2.5 is linked to higher all-cause mortality and to hospital admissions for Parkinson’s disease and diabetes among US Medicare enrollees.
Source
A national case-crossover analysis of the short-term effect of PM2.5 on hospitalizations and mortality in subjects with diabetes and neurological disorders
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Short-term PM2.5 raises deaths and Parkinson’s admissions
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6,982,678 deaths among Medicare enrollees in 121 US communities, 1999–2010
From the Medicare beneficiary denominator file we selected 6,982,678 deaths among all Medicare enrollees during the period 1999 to 2010 in 121 US communities.
Did prior neurological hospitalization significantly modify mortality risk?
While those risks were not significantly higher than the mortality risk associated with short-term effect of PM 2.5 among then Medicare enrollees that were never hospitalized for any of these diseases, there was a pattern of higher estimates.
What they did
Authors used a multi-city case-crossover of Medicare deaths and emergency hospitalizations (1999–2010) in 121 US communities, relating the two-day average of PM2.5 to all-cause mortality and to admissions for diabetes and neurological disorders.
What they found
Each 10 μg/m³ two-day PM2.5 raised all-cause mortality 0.64%. Admissions rose 3.23% for Parkinson’s disease and 1.14% for diabetes. Mortality estimates were larger, though not significantly so, among people with prior diabetes, Parkinson’s, dementia, or Alzheimer’s admissions. Effects appeared at lag 0 and lasted 2–3 days.
The limits
What it doesn't show
Medicare captures only hospitalized neurological disease, so milder dementia is missed. Differences versus people never hospitalized for these conditions were not statistically significant. The study does not prove particles enter the brain or cause disease onset.
Key terms
- PM2.5
- Fine particulate matter with aerodynamic diameter less than 2.5 μm.
- Case-crossover
- A design that compares a person’s exposure on event days with exposure on nearby control days, controlling for slow-changing confounders.
- Two-day average
- Mean of same-day (lag 0) and previous-day (lag 1) PM2.5.
- Medicare
- US health insurance for people 65 and older, here supplying death and hospital records.
- Effect modification
- Whether a prior diagnosis changes the size of the PM2.5–mortality association.
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The main PM2.5 exposure window was:
Common questions
Are people with neurological disease uniquely susceptible?
Mortality estimates were higher with prior diabetes or neurological admissions, but those differences were not statistically significant.
Which hospitalizations clearly rose with PM2.5?
Parkinson’s disease (3.23%) and diabetes (1.14%) per 10 μg/m³.
How fast is the effect?
Immediate at lag 0 and still present for 2- or 3-day averages.
Why might Alzheimer’s admissions differ by age?
Age modified Alzheimer’s hospitalizations: +3.48% at ages 65–75 versus no increase over 75.
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