Hospital admission risks and excess costs for neurological symptoms attributable to long-term exposure to fine particulate matter in New York State, USA

• Published in: Environmental research Vol. 229; p. 115954
• Main Authors: Min, Jieun, Lee, Whanhee, Bell, Michelle L., Kim, Yijun, Heo, Seulkee, Kim, Ga Eun, Kim, Jee Hyun, Yun, Ji Young, Kim, Soo In, Schwartz, Joel, Ha, Eunhee
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 15.07.2023
• Subjects: Air Pollutants - analysis; Air Pollution - analysis; Bayes Theorem; Environmental Exposure - adverse effects; Environmental Exposure - analysis; Excess cost; Fine particulate matter; Headache - chemically induced; Hospital admission; Hospitals; Humans; Neurological symptom; New WHO air quality guidelines; New York - epidemiology; New York state; Particulate Matter - analysis; Seizures - chemically induced; New York; Excess cost; Neurological symptom; New York state; Fine particulate matter; New WHO air quality guidelines; Hospital admission
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2023.115954

Although emerging evidence suggests that PM2.5 is linked to neurological symptoms (NSs) via neuroinflammation, relevant studies are scarce. This study aimed to investigate the risks and excess costs of hospital admission for five NSs—fatigue, headache, dizziness, convulsion, and paralysis—attributable to long-term exposure to PM2.5 in New York State, USA. We analyzed the New York Statewide Planning and Research Cooperative System (SPARCS) from 2010 to 2016. A Bayesian hierarchical model with integrated nested Laplace approximations was performed to estimate the risks and excess costs of hospital admission for NSs due to long-term exposure to PM2.5 at the county level. A 1 μg/m3 increase in lag 0–1 years PM2.5 was associated with an increased risk of headache and convulsion by 1.06 (95% CI: 1.01, 1.11) and 1.04 (95% CI: 1.01, 1.06), respectively. The excess hospital admission cost for five NSs attributable to lag 0–1 years PM2.5 above the new World Health Organization guideline (annual standard: 5 μg/m3) was $200.24 (95% CI: 6.00, 376.96) million during 2011–2016, recording the highest for convulsion ($153.73 [95% CI: 63.61, 244.19] million). This study provides quantitative estimates of risks and excess costs for NSs attributable to long-term PM2.5 and suggests that policies that reduce long-term PM2.5 concentration in accordance with the new WHO air quality guidelines can yield substantial health and economic benefits related to NSs in the New York State population. •Hospital admissions for neurological symptoms are positively associated with PM2.5.•The association was higher in female than male, despite the absence of statistical significance.•The association was higher in Other races than non-Hispanic White and Black.•The excess cost due to noncompliance with the WHO air quality guideline is substantial.