Fine particulate air pollution and its components in association with cause-specific emergency admissions

Background: Although the association between exposure to particulate matter and health is well established, there remains uncertainty as to whether certain chemical components are more harmful than others. We explored whether the association between cause-specific hospital admissions and PM2.5 was modified by PM2.5 chemical composition. Methods: We estimated the association between daily PM2.5 and emergency hospital admissions for cardiac causes (CVD), myocardial infarction (MI), congestive heart failure (CHF), respiratory disease, and diabetes in 26 US communities, for the years 2000-2003. Using meta-regression, we examined how this association was modified by season-and community-specific PM2.5 composition, controlling for seasonal temperature as a surrogate for ventilation. Results: For a 10 mu g/m(3) increase in 2-day averaged PM2.5 concentration we found an increase of 1.89% (95% CI: 1.34-2.45) in CVD, 2.25% (95% CI: 1.10-3.42) in MI, 1.85% (95% CI: 1.19-2.51) in CHF, 2.74% (95% CI: 1.30-4.2) in diabetes, and 2.07% (95% CI: 1.20-2.95) in respiratory admissions. The association between PM2.5 and CVD admissions was significantly modified when the mass was high in Br, Cr, Ni, and Na+, while mass high in As, Cr, Mn, OC, Ni, and Na+ modified MI, and mass high in As, OC, and SO42- modified diabetes admissions. For these species, an interquartile range increase in their relative proportion was associated with a 1-2% additional increase in daily admissions per 10 mu g/m(3) increase in mass. Conclusions: We found that PM2.5 mass higher in Ni, As, and Cr, as well as Br and OC significantly increased its effect on hospital admissions. This result suggests that particles from industrial combustion sources and traffic may, on average, have greater toxicity.