Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Dvonch, J.T., S. Kannan, A.J. Schulz, G.J. Keeler, G. Mentz, James S. House, A. Benjamin, P. Max, R.L. Bard, and R.D. Brook. 2009. "Acute Effects of Ambient Particulate Matter on Blood Pressure Differential Effects Across Urban Communities." Hypertension, 53(5): 853-859.
Recent studies have suggested a link between exposure to ambient particulate matter <2.5 mu m in diameter (PM2.5) and adverse cardiovascular outcomes. The objective of this study was to examine the effects of differing community-level exposure to PM2.5 on daily measures of blood pressure (BP) among an adult population. During the period May 2002 through April 2003, BP was examined at 2 time points for 347 adults residing in 3 distinct communities of Detroit, Michigan. Exposure to PM2.5 was assessed in each community during this period, along with multivariate associations between PM2.5 and BP. In models combining all 3 of the communities, PM2.5 was significantly associated with systolic blood pressure; a 10-mu g/m(3) increase in daily PM2.5 was associated with a 3.2-mm Hg increase in systolic blood pressure (P=0.05). However, in models that added a location interaction, larger effects were observed for systolic blood pressure within the community with highest PM2.5 levels; a 10-mu g/m(3) increase in daily PM2.5 was associated with a 8.6-mm Hg increase in systolic blood pressure (P=0.01). We also found young age (<55 years) and not taking BP medications to be significant predictors of increased BP effects. Among those taking BP medications, the PM2.5 effect on BP appeared to be mitigated, partially explaining the age effect, because those participants <55 years of age were less likely to take BP medications. Short-term increases in exposure to ambient PM2.5 are associated with acute increases in BP in adults, especially within communities with elevated levels of exposure. (Hypertension. 2009; 53: 853-859.)
Country of focus: United States.