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U.S. air- -quality standards are designed to restrict quality standards are designed to restrict U.S. air ambient pollutant concentrations in and effort to ambient pollutant concentrations in and effort to protect human health. protect human
New England Journal of Medicine New England Journal of Medicine January 22, 2009 January 22, 2009
Pope C et al. N Engl J Med 2009;360:376-386
Distribution of Study Areas
Pope C et al. N Engl J Med 2009;360:376-386
Cross-Sectional Life Expectancies for 1978-1982, Plotted against PM2.5 Concentrations for 1979- 1983
Pope C et al. N Engl J Med 2009;360:376-386
Cross-Sectional Life Expectancies for 1997-2001, Plotted against PM2.5 Concentrations for 1999- 2000
Pope C et al. N Engl J Med 2009;360:376-386
Changes in Life Expectancy for the 1980s-1990s, Plotted against Reductions in PM2.5 Concentrations for 1980-2000
New England Journal of Medicine New England Journal of Medicine January 22, 2009 January 22, 2009
California Cities California Cities Decrease in Decrease in PM 2.5 PM 2.5 Gain in life Gain in life expectance expectance (months.) (months.) Life expectancy Life expectancy (years) (years) San Jose San Jose 3.2 3.2 4.2 4.2 80.3 80.3 San Diego San Diego 3.2 3.2 2.3 2.3 78.5 78.5 Los Angeles Los Angeles 6.6 6.6 4.1 4.1 78.1 78.1 San Francisco San Francisco 3.9 3.9 4.5 4.5 77.9 77.9
Disease and Intervention Disease and Intervention Cardiovascular disease Cardiovascular disease Statin Statin for low LDL/ high CRP for low LDL/ high CRP Achievement 20% cessation rate in Achievement 20% cessation rate in smokers smokers Reduction of diastolic BP to 88 Reduction of diastolic BP to 88 if 90 if 90 -
94 Reduction of total cholesterol to Reduction of total cholesterol to 200mg/dl If 200 to 239 mg/dl 200mg/dl If 200 to 239 mg/dl 200mg/dl if 240 to 299 mg/dl 200mg/dl if 240 to 299 mg/dl Cancer prevention Cancer prevention 10 years of biannual 10 years of biannual mammography for 50y/o women mammography for 50y/o women Pap smear every 3 years for 55 Pap smear every 3 years for 55 years for 20 years for 20 y/o y/o women women Colonoscopy every 5 years for 25 Colonoscopy every 5 years for 25 years in 50 year olds. years in 50 year olds. Gain in Life Expectancy Gain in Life Expectancy (in months (in months) ) Men Women Men Women 10.2 7.9 10.2 7.9 5.5 6.7 5.5 6.7 13.2 10.8 13.2 10.8 6.0 4.8 6.0 4.8 20.4 18.0 20.4 18.0 0.8 0.8 3.1 3.1 2.5 2.2 2.5 2.2
Pope C et al. N Engl J Med 2009;360:376-386
Summary Characteristics of the 217 Counties Analyzed
Pope C et al. N Engl J Med 2009;360:376-386
Results of Selected Regression Models, Including Estimates of the Increase in Life Expectancy Associated with a Reduction in PM2.5 of 10 {micro}g per Cubic Meter, Adjusted for Socioeconomic, Demographic, and Proxy Indicators for Prevalence of Smoking
Krewski D. N Engl J Med 2009;360:413-415
Estimates of Increased Mortality Associated with an Increase in PM2.5 Concentrations of 10 {micro}g per Cubic Meter Based on Extended Follow-up of the American Cancer Society Cancer Prevention Study II