Long-term exposure to PM_2.5 and incidence of disability in activities of daily living among oldest old

Authors

Yuebin Lv
Jinhui Zhou
Virginia Byers Kraus
Tiantian Li
Jeremy A. Sarnat
Jiaonan Wang
Yang Liu
Huashuai Chen
Melanie S. Brasher, University of Rhode IslandFollow
Cheng Mao
Yi Zeng
Xiaoming Shi

Document Type

Article

Date of Original Version

2020

Abstract

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM_2.5) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM_2.5 exposure with a threshold concentration of 33 μg/m³, and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM_2.5 concentrations; compared to 33 μg/m³, the hazard ratio ranged from 1.03 (1.00–1.06) at 40 μg/m³ to 2.25 (1.54–3.29) at 110 μg/m³. The risk magnitude was not significantly changed below this threshold. Each 10 μg/m³ increase in PM_2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051–1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM_2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m³, and supported that reduction to current World Health Organization interim target-1value (35 μg/m³) and Chinese national ambient air quality standards (35 μg/m³) or lower may be associated with lower risk of disability in ADL.

Publication Title, e.g., Journal

Environmental Pollution

Volume

259

Citation/Publisher Attribution

Lv, Y., Zhou, J., Kraus, V. B., Li, T., Sarnat, J. A., Wang, J., Liu, Y., Chen, H., Brasher, M. S., Mao, C., Zeng, Y., Zheng, T., & Shi, X. (2020). Long-term exposure to PM_2.5 and incidence of disability in activities of daily living among oldest old. Environmental pollution (Barking, Essex : 1987), 259, 113910. https://doi.org/10.1016/j.envpol.2020.113910

Available at: https://doi.org/10.1016/j.envpol.2020.113910