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Francesca Dominici, PhD; Roger D. Peng, PhD; Michelle L. Bell, PhD; Luu Pham, MS; Aidan McDermott, PhD; Scott L. Zeger, PhD; Jonathan M. Samet, MD

JAMA. 2006;295:1127-1134.

Context  Evidence on the health risks associated with short-term exposure to fine particles (particulate matter 2.5 µm in aerodynamic diameter [PM_2.5]) is limited. Results from the new national monitoring network for PM_2.5 make possible systematic research on health risks at national and regional scales.

Objectives  To estimate risks of cardiovascular and respiratory hospital admissions associated with short-term exposure to PM_2.5 for Medicare enrollees and to explore heterogeneity of the variation of risks across regions.

Design, Setting, and Participants  A national database comprising daily time-series data daily for 1999 through 2002 on hospital admission rates (constructed from the Medicare National Claims History Files) for cardiovascular and respiratory outcomes and injuries, ambient PM_2.5 levels, and temperature and dew-point temperature for 204 US urban counties (population >200 000) with 11.5 million Medicare enrollees (aged >65 years) living an average of 5.9 miles from a PM_2.5 monitor.

Main Outcome Measures  Daily counts of county-wide hospital admissions for primary diagnosis of cerebrovascular, peripheral, and ischemic heart diseases, heart rhythm, heart failure, chronic obstructive pulmonary disease, and respiratory infection, and injuries as a control outcome.

Results  There was a short-term increase in hospital admission rates associated with PM_2.5 for all of the health outcomes except injuries. The largest association was for heart failure, which had a 1.28% (95% confidence interval, 0.78%-1.78%) increase in risk per 10-µg/m³ increase in same-day PM_2.5. Cardiovascular risks tended to be higher in counties located in the Eastern region of the United States, which included the Northeast, the Southeast, the Midwest, and the South.

Conclusion  Short-term exposure to PM_2.5 increases the risk for hospital admission for cardiovascular and respiratory diseases.

Author Affiliations: Departments of Biostatistics (Drs Dominici, Peng, McDermott, and Zeger and Mr Pham) and Epidemiology (Dr Samet), Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md; and School of Forestry and Environmental Studies, Yale University, New Haven, Conn (Dr Bell).

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