Study links air pollution to nine causes of death

A new study has identified nine specific causes of death that are related to exposure to ambient fine particulate matter air pollution.

Moreover, the data, which were published in JAMA Network Open, indicate that black people and those living in socioeconomically disadvantaged communities are disproportionally affected by death associated with air pollution.

Results from the longitudinal cohort study of 4,522,160 veterans in the contiguous United States followed from 2006 to 2016 linked exposure to fine particulate matter (PM_2.5) with an excess burden of death due to the following:

• cardiovascular disease (56,070.1 deaths; 95% uncertainty interval [UI], 51,940.2-60,318.3);
• cerebrovascular disease (40,466.1 deaths; 95% UI, 21,770.1-46,487.9);
• chronic kidney disease (7,175.2 deaths; 95% UI, 5,910.2-8,371.9);
• COPD (645.7 deaths; 95% UI, 300.2-2,490.9);
• dementia (19,851 deaths; 95% UI, 14,420.6-31,621.4);
• type 2 diabetes (501.3 deaths; 95% UI, 447.5-561.1);
• hypertension (30,696.9 deaths; 95% UI, 27,518.1-33,881.9);
• lung cancer (17,545.3 deaths; 95% UI, 15,055.3-20,464.5); and
• pneumonia (8,854.9 deaths; 95% UI, 7,696.2-10,710.6).

Overall, after calibration, the burden of death due to nonaccidental causes and noncommunicable diseases associated with PM_2.5 was 197,905.1 deaths (95% UI, 183,463.3-213,644.9) and 188,540.3 deaths (95% uncertainty interval, 173,883.7-209,786.3), respectively. Additionally, estimated age-standardized death rates were 51.4 per 100,000 persons for nonaccidental causes and 48.4 per 100,000 persons for noncommunicable diseases.

Notably, there was significant geographic variation in burden of death related to PM_2.5 exposure, with age-standardized death rates due to nonaccidental causes and noncommunicable diseases appearing to cluster in parts of the Midwest, Appalachia and the South.

Furthermore, the mean age-standardized death rates due to nonaccidental causes were higher among black people vs. nonblack people (55.2 vs. 51 per 100,000) and among those living in counties with high vs. low socioeconomic deprivation (65.3 vs. 46.1 per 100,000).

The researchers also found that the 99% of the estimated burden of death due to nonaccidental causes and noncommunicable diseases were related to PM_2.5 concentrations below the current Environmental Protection Agency guidelines.

“We provide evidence of an association between PM_2.5 air pollution and nine causes of death — expanding by three the list of specific causes of death associated with ambient particulate matter air pollution,” the researchers wrote.

“Our results provide further evidence that racial disparities and nonracial socioeconomic disparities contribute measurably and independently to the burden of death associated with PM_2.5 exposure. Finally, we provide estimates that nearly all deaths attributable to air pollution in the contiguous United States are associated with ambient air pollution concentrations below the current EPA standards, a finding that both reflects past success and suggests that more stringent PM2.5 air quality standards may further reduce the national death toll associated with air pollution.” – by Melissa Foster

Disclosures: The authors report no relevant financial disclosures.