Indoor Exposure to "Outdoor PM10" Assessing Its Influence on the Relationship Between PM10 and Short-term Mortality in US Cities : Assessing Its Influence on the Relationship Between PM10 and Short-term Mortality in U.S. Cities

Background: Seasonal and regional differences have been reported for the increase in short-term mortality associated with a given increase in the concentration of outdoor particulate matter with an aerodynamic diameter smaller than 10 mu m (PM10 mortality coefficient). Some of this difference may be because of seasonal and regional differences in indoor exposure to PM10 of outdoor origin.

Methods: From a previous study, we obtained PM10 mortality coefficients for each season in seven U.S. regions. We then estimated the change in the sum of indoor and outdoor PM10 exposure per unit change in outdoor PM10 exposure (PM10 exposure coefficient) for each season in each region. This was originally accomplished by estimating PM10 exposure coefficients for 19 cities within the regions for which we had modeled building infiltration rates.

We subsequently expanded the analysis to include 64 additional cities with less well-characterized building infiltration rates. Results: The correlation (r = 0.71 [95% confidence interval = 0.46 to 0.86]) between PM10 mortality coefficients and PM10 exposure coefficients (28 data pairs; four seasons in each of seven regions) was strong using exposure coefficients derived from the originally targeted 19 National Morbidity, Mortality, and Air Pollutions Study cities within the regions.

The correlation remained strong (r = 0.67 [0.40 to 0.84]) when PM10 exposure coefficients were derived using 83 cities within the regions (the original 19 plus the additional 64). Conclusions: Seasonal and regional differences in PM10 mortality coefficients appear to partially reflect seasonal and regional differences in total PM10 exposure per unit change in outdoor exposure.