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Brief Report: Ambient PM2.5 and Risk of Hospital Admissions

Bell, Michelle L.a; Son, Ji-Younga; Peng, Roger D.b; Wang, Yunc; Dominici, Francescac

doi: 10.1097/EDE.0000000000000310
Air Pollution

Background: While strong evidence exists for associations between fine particles (PM2.5) and health, less is known about whether associations differ by sex.

Methods: We used Bayesian hierarchical modeling to estimate associations between PM2.5, based on ambient monitors, and risk of cause-specific cardiovascular and respiratory hospitalizations for about 12.6 million Medicare beneficiaries (>65 years) residing in 213 US counties for 1999–2010.

Results: Point estimates were higher for women than men for almost all causes of hospitalization. PM2.5 risks were higher for women than men for respiratory tract infection, cardiovascular, and heart rhythm disturbance admissions. A 10 μg/m3 increase in same-day PM2.5 was associated with a 1.13% increased risk of heart rhythm disturbance admissions for women (95% posterior interval [PI]: 0.63%, 1.63%), and 0.03% for men (95% PI: -0.48%, 0.55%). Differences remained after stratification by age and season.

Conclusions: Women may be more susceptible to PM2.5-related hospitalizations for some respiratory and cardiovascular causes.

Supplemental Digital Content is available in the text.

From the aSchool of Forestry and Environmental Studies, Yale University, New Haven, CT; bDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and cDepartment of Biostatistics, T.H. Chan School of Public Health, Harvard University, Cambridge, MA.

Submitted 16 October 2014; accepted 31 March 2015.

The authors report no conflicts of interest.

Supported by the US EPA (EPA RD 83479801), NIEHS (R01ES019560, R21ES022585, R01 ES019560, R21ES024012, K18 HS021991), and the Health Effects Institute (4909-RFA11-1/12–3).

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the authors.

Correspondence: Michelle L. Bell, Yale University, 195 Prospect Street, New Haven, CT 06511. E-mail:

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