Wildfire-specific Fine Particulate Matter and Risk of Hospital Admissions in Urban and Rural Counties.
Wildfire-specific Fine Particulate Matter and Risk of Hospital Admissions in Urban and Rural Counties.
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DOI：
10.1097/ede.0000000000000556
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发表时间：
2017-01
期刊：
影响因子：
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通讯作者：
Bell ML
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文献类型：
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作者：
Liu JC;Wilson A;Mickley LJ;Dominici F;Ebisu K;Wang Y;Sulprizio MP;Peng RD;Yue X;Son JY;Anderson GB;Bell ML
野火烟雾（包括细颗粒物（PM2.5））对健康的影响尚未得到很好的理解，并且由于浓度和化学成分的差异，可能与其他来源的PM2.5不同。首先，对于整个美国西部（561个县）2004-2009年，我们估计每天的PM2.5浓度直接归因于野火（野火特定的PM2.5），使用全球化学传输模型。其次，我们将烟波定义为≥连续2天，每日野火特定PM2.5>20µg/m3，敏感性分析考虑23µg/m3，28µg/m3和37µg/m3。第三，我们估计了医疗保险登记者与烟雾波相关的心血管和呼吸系统住院的风险。我们使用广义线性混合模型来估计与没有野火烟雾的匹配比较日相比，烟雾波日住院的相对风险。我们估计，在2004年至2009年期间，美国西部约有4600万各年龄段的人暴露于至少一次烟雾波。其中，500万人是Medicare登记者（≥ 65岁）。我们发现，与匹配的非烟雾波日相比，在烟雾波日期间，具有高野火特异性PM2.5（>37µg/m3）的呼吸入院风险增加了7.2%（95%置信区间：0.25%，15%）。我们没有观察到野火PM2.5 ≤37µg/m3的烟雾波天数与呼吸或心血管入院之间的相关性。野火PM2.5的呼吸效应可能比其他来源的PM2.5更强。短期暴露于野火特异性PM2.5与美国西部严重烟雾日老年人群呼吸道疾病的风险相关。
The health impacts of wildfire smoke, including fine particles (PM2.5), are not well understood and may differ from those of PM2.5 from other sources due to differences in concentrations and chemical composition. First, for the entire Western US (561 counties) for 2004–2009, we estimated daily PM2.5 concentrations directly attributable to wildfires (wildfires-specific PM2.5), using a global chemical transport model. Second, we defined smoke wave as ≥2 consecutive days with daily wildfire-specific PM2.5>20µg/m3, with sensitivity analysis considering 23µg/m3, 28µg/m3, and 37µg/m3. Third, we estimated the risk of cardiovascular and respiratory hospital admissions associated with smoke waves for Medicare enrollees. We used a generalized linear mixed model to estimate the relative risk of hospital admissions on smoke wave days compared to matched comparison days without wildfire smoke. We estimated that about 46 million people of all ages were exposed to at least one smoke wave during 2004 to 2009 in the Western US. Of these, 5 million are Medicare enrollees (≥65y). We found a 7.2% (95% confidence interval: 0.25%, 15%) increase in risk of respiratory admissions during smoke wave days with high wildfire-specific PM2.5 (>37µg/m3) compared to matched non-smoke-wave days. We did not observe an association between smoke wave days with wildfire-PM2.5≤37µg/m3 and respiratory or cardiovascular admissions. Respiratory effects of wildfire-specific PM2.5 may be stronger than that of PM2.5 from other sources. Short-term exposure to wildfire-specific PM2.5 was associated with risk of respiratory diseases in the elderly population in the Western US during severe smoke days.