Hospital admission risks and excess costs for neurological symptoms attributable to long-term exposure to fine particulate matter in New York State, USA

Background: Although emerging evidence suggests that PM_2.5 is linked to neurological symptoms (NSs) via neuroinflammation, relevant studies are scarce. This study aimed to investigate the risks and excess costs of hospital admission for five NSs—fatigue, headache, dizziness, convulsion, and paralysis—attributable to long-term exposure to PM_2.5 in New York State, USA. Methods: We analyzed the New York Statewide Planning and Research Cooperative System (SPARCS) from 2010 to 2016. A Bayesian hierarchical model with integrated nested Laplace approximations was performed to estimate the risks and excess costs of hospital admission for NSs due to long-term exposure to PM_2.5 at the county level. Results: A 1 μg/m³ increase in lag 0–1 years PM_2.5 was associated with an increased risk of headache and convulsion by 1.06 (1.01, 1.11) and 1.04 (1.01, 1.06), respectively. The excess hospital admission cost for five NSs attributable to lag 0–1 years PM_2.5 above the new World Health Organization guideline (annual standard: 5 μg/m³) was $200.24 (95% CI: 6.00, 376.96) million during 2011–2016, recording the highest for convulsion ($153.73 [95% CI: 63.61, 244.19] million). Conclusions: This study provides quantitative estimates of risks and excess costs for NSs attributable to long-term PM_2.5 and suggests that policies that reduce long-term PM_2.5 concentration in accordance with the new WHO air quality guidelines can yield substantial health and economic benefits related to NSs in the New York State population.