Evidence map›Paper›PMID 26600257›Full record

ArticleEpidemiology (Cambridge, Mass.)2016

PM2.5 and Mortality in 207 US Cities: Modification by Temperature and City Characteristics.

Marianthi-Anna Kioumourtzoglou, Joel Schwartz, Peter James, Francesca Dominici, Antonella Zanobetti

Abstract read
In one paragraph

Article in Epidemiology (Cambridge, Mass.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Short- and intermediate-term exposure to NOEnvironmental pollution (Barking, Essex : 1987) · 2020
    Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Article
  7. Excess risk of heat-related hospitalization associated with temperature and PMEnvironmental epidemiology (Philadelphia, Pa.) · 2026
    Article
  8. Review
  9. Article
  10. Article
  11. Long-term exposure to ambient PMEnvironmental epidemiology (Philadelphia, Pa.) · 2025
    Article
  12. Potential causal links of long-term PMSustainable cities and society · 2025
    Article
  13. Article
  14. Interactive effects between extreme temperatures and PMEnvironmental research letters : ERL [Web site] · 2025
    Article
  15. Article
  16. Article
  17. [Impact of fine particulate matter exposure on non-accidental mortality under different apparent temperature levels].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2024
    Article
  18. Article
  19. Article
  20. Long-term exposure to PMBMC public health · 2024
    Article

31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Marianthi-Anna KioumourtzoglouFrom the Departments of aEnvironmental Health, bEpidemiology, & cBiostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.
Joel Schwartz
Peter James
Francesca Dominici
Antonella Zanobetti

Funding

Translational Research Support CoreP30ES000002 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI SUSAN A KORRICK · 1985 to 2026
$44.6M
Training Program in Environmental EpidemiologyT32ES007069 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI LADEN, FRANCINE · 1985 to 2024
$13.9M
CVD Epidemiology Training Program in Behavior, the Environment and Global HealthT32HL098048 · NHLBI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Goodarz Danaei, ERIC B RIMM · 2009 to 2026
$6.9M
Cardiovascular Health and Air Pollution: A National StudyR01ES024332 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI ZANOBETTI, ANTONELLA · 2015 to 2018
$2.5M
Statistical Methods for Complex Enivronmental Health DataR01ES019560 · NIEHS · JOHNS HOPKINS UNIVERSITY · PI PENG, ROGER · 2011 to 2015
$1.8M
Air Pollution and Pregnancy Outcome in New York CityR01ES019955 · NIEHS · BROWN UNIVERSITY · PI SAVITZ, DAVID A · 2011 to 2013
$1.3M
Extreme Heat and Human Health: Characterizing Vulnerability in a Changing ClimateR21ES020152 · NIEHS · JOHNS HOPKINS UNIVERSITY · PI PENG, ROGER · 2011 to 2012
$482k
Vulnerability and Adaptation to Heat and Air Pollution in a Changing ClimateR21ES022585 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI DOMINICI, FRANCESCA · 2014 to 2015
$454k
Chronic effects of weather fluctuations: population susceptibility and adaptationR21ES024012 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI ZANOBETTI, ANTONELLA · 2014 to 2015
$445k
NHLBI NIH HHS T32 HL 098048NHLBI NIH HHS T32 HL098048NIEHS NIH HHS P30 ES000002NIEHS NIH HHS R01 ES019560NIEHS NIH HHS R01 ES019955NIEHS NIH HHS R01 ES024332NIEHS NIH HHS R21 ES020152NIEHS NIH HHS R21 ES022585NIEHS NIH HHS R21 ES022585-01NIEHS NIH HHS R21 ES024012NIEHS NIH HHS T32 ES007069
6 · The paper itself

Abstract

backgroundThe reported estimated effects between long-term PM2.5 exposures and mortality vary spatially. We assessed whether community-level variables, including socioeconomic status indicators and temperature, modify this association.

methodsWe used data from >35 million Medicare enrollees from 207 US cities (2000-2010). For each city, we calculated annual PM2.5 averages, measured at ambient central monitoring sites. We used a variation of a causal modeling approach and fitted city-specific Cox models, which we then pooled using a random effects meta-regression. In this second stage, we assessed whether temperature and city-level variables, including smoking and obesity rates, poverty, education and greenness, modify the long-term PM2.5-mortality association.

resultsWe found an association between long-term PM2.5 and survival (hazard ratio = 1.2; 95% confidence interval [CI]: 1.1, 1.3 per 10 μg/m increase in the annual PM2.5 average concentrations). We observed elevated estimates in the Southeastern, South and Northwestern US (hazard ratio = 1.9; 95% CI: 1.7, 2.2, and 1.4; 95% CI: 1.2, 1.7, and 1.4; 95% CI: 1.1, 1.9, respectively). We observed a higher association between long-term PM2.5 exposure and mortality in warmer cities. Furthermore, we observed increasing estimates with increasing obesity rates, %residents and families in poverty, %black residents and %population without a high school degree, and lower effects with increasing median household income and %white residents.

conclusionsTo the best of our knowledge, this is the first study to assess modification by temperature and community-level characteristics on the long-term PM2.5-survival association. Our findings suggest that living in cities with high temperatures and low socio economic status (SES) is associated with higher effect estimates.

Indexed as

MortalityParticulate MatterTemperatureAgedAged, 80 and overCitiesEducational StatusEthnicityFemaleHumansIncomeMaleMedicareObesityPovertyProportional Hazards ModelsParticulate Matter

Identifiers

PMID26600257
PMCPMC4748718

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.