Abstract
BACKGROUND AND PURPOSE: Acute exposure to particulate matter with aerodynamic diameter <2.5 μm (PM(2.5)) is associated with acute cardiovascular and cerebrovascular mortality. The aim of this study was to evaluate these associations with specific causes of cardiovascular and cerebrovascular mortality in Mexico City. METHODS: We obtained daily mortality records for Mexico City from 2004 to 2013 for cardiovascular and cerebrovascular causes in people ≥25 and ≥65 years old. Exposure to PM(2.5) was assessed with daily estimates from a new hybrid spatiotemporal model using satellite measurements of aerosol optical depth PM(2.5) and compared to ground level PM(2.5) measurements with missing data estimated with generalized additive models PM(2.5). We fitted Poisson regression models with distributed lags for all mortality outcomes. RESULTS: An increase of 10 µg/m(3) in aerosol optical depth PM(2.5) was associated with increased cardiovascular (1.22%; 95% confidence interval, 0.17-2.28) and cerebrovascular mortality (3.43%; 95% confidence interval, 0.10-6.28) for lag days 0 to 1 (lag 0-1). Stronger effects were identified for hemorrhagic stroke and people ≥65 years. Associations were slightly smaller using generalized additive models PM(2.5). CONCLUSIONS: These results support the evidence that acute exposure to PM(2.5) is associated with increased risk of specific cardiovascular and cerebrovascular mortality causes.