Year of Publication

2019

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Steven Browning

Committee Member

Dr. W. Jay Christian

Committee Member

Dr. Bin Huang

Abstract

Aim: To identify PM2.5 as a risk factor for chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) respectively, and to explore the magnitude of the association of PM2.5 with the coexistence of CHD and COPD, by using the combined dataset of 1999-2014 EPA Air Data and 2017 BRFSS SMART data (age 18 and older).

Methods: Cross-sectional study was designed to identify the association between PM2.5 exposure and COPD and CHD. The PM2.5 exposure values were adapted from the county-level EPAAir Data, the yearly mean values of PM2.5 were used to determine the association. Characteristics of sex, age, race, health status, and socioeconomic status were obtained from the BRFSS SMART data. Binary logistic regressions using binary/two-level (“high-level” and “low-level” determined by EPA National Ambient Air Quality Standards) PM2.5 exposure values and continuous PM2.5 exposure values respectively were applied to identity the association between PM2.5 exposure and target health outcomes.

Results: Adjusted odds ratios (AOR) (with adjustments of sex, race, education, and income) between binary PM2.5 and CHD among elderly group (with age equal to or older than 65) was 1.074 (P<0.05, 95% CI 1.017-1.134); the same association among younger group (with age younger than 65) was not significant. A significant association between binary PM2.5 and COPD was observed (for elderly group, AOR=1.129 95% CI 1.072-1.188; for younger group, AOR=1.195 95% CI 1.136-1.257). 2448 (1.4%)

respondents reported that had ever been told have both CHD and COPD, there was a

significant association between binary PM2.5 and the coexistence of COPD and CHD among the elderly population (AOR=1.168 95% CI 1.054-1.295). Associations between continuous PM2.5 (adjusted by per 5 µg/m3 increase) and the outcomes suggested the same trend of results.

Conclusions: The association between PM2.5 and CHD was not as strong as the association between PM2.5 and COPD. However, the association between PM2.5 and the coexistence of CHD and COPD among elderly population was stronger than the associations between PM2.5 and either of them, according to the AOR. These finds may help with the diagnosis of CHD within populations that have COPD, especially in high PM2.5 exposure areas. Future studies that can determine the temporal sequence of association are required to figure out the association between COPD and CHD regarding to the PM2.5 exposure.

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