{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:47:00Z","timestamp":1791838020652,"version":"4.3.4"},"reference-count":35,"publisher":"American Chemical Society (ACS)","issue":"6","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["R01ES036436"],"award-info":[{"award-number":["R01ES036436"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["R01AG066793"],"award-info":[{"award-number":["R01AG066793"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["RF1AG080948"],"award-info":[{"award-number":["RF1AG080948"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Education","award":["RS-2025-25442252"],"award-info":[{"award-number":["RS-2025-25442252"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hospital readmissions are a major concern among people living with Alzheimer\u2019s disease and related dementias (ADRD), contributing to substantial burden on patients, caregivers, and health care systems. We evaluated whether short-term exposure to fine particulate matter (PM2.5) was associated with 30-day all-cause readmission among older adults with ADRD and whether residential green and blue space modified this association. We conducted a nationwide time-stratified case-crossover study using Medicare fee-for-service inpatient claims from 2000 to 2016 in the contiguous United States. We identified 30-day all-cause readmissions following the first index admission with ADRD. Daily modeled PM2.5 concentrations were linked to residential ZIP Codes, and exposure windows up to lag 2 days were examined. Measures of green and blue space were derived from Landsat and Google Street View data. Conditional logistic regression was used to estimate associations between PM2.5 and readmission with interaction terms used to evaluate effect modification by levels of green and blue space. Among 6,098,836 beneficiaries with an index admission with ADRD, 759,128 (12.4%) experienced a 30-day all-cause readmission. An interquartile range (IQR; 7.2 \u03bcg\/m3) increase in PM2.5 averaged over lag 0 to 2 days was associated with a higher risk of readmission (odds ratio: 1.010; 95% confidence interval: 1.006, 1.015). Associations were higher for beneficiaries with longer intervals to readmission (&amp;gt;7 days). Effect modification by green or blue space was not conclusive. These findings suggest that short-term PM2.5 exposure may increase the risk of 30-day all-cause hospital readmission among Medicare beneficiaries with ADRD. Reducing ambient PM2.5 exposure may help prevent avoidable readmissions and lessen burden on patients, caregivers, and health care systems.<\/jats:p>","DOI":"10.1021\/ehp.6c00147","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:02:29Z","timestamp":1787072549000},"page":"707-714","source":"Crossref","is-referenced-by-count":0,"title":["PM2.5 and 30-Day Readmission in Medicare\nBeneficiaries with Alzheimer\u2019s Disease and Related Dementias:\nEffect Modification by Neighborhood Green and Blue Space"],"prefix":"10.1021","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2603-6250","authenticated-orcid":true,"given":"Garam","family":"Byun","sequence":"first","affiliation":[{"name":"Yale University , , , ,","place":["New Haven, Connecticut, United States, 06511"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott W.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mork","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahima","family":"Kaur","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongsoo","family":"Choi","sequence":"additional","affiliation":[{"name":"Yale University , , , ,","place":["New Haven, Connecticut, United States, 06511"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Zanobetti","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0731-6628","authenticated-orcid":true,"given":"Jenny Jyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Ewha Womans University , , ,","place":["Seoul, Republic of Korea, 03760"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"Benmarhnia","sequence":"additional","affiliation":[{"name":"University of California San Diego , , , ,","place":["La Jolla, California, United States, 92037"]},{"name":"University of Rennes, EHESP , , ,","place":["Rennes, France, 35000"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"James","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]},{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute , , , ,","place":["Boston, Massachusetts, United States, 02215"]},{"name":"University of California, Davis , , , ,","place":["Davis, California, United States, 95616"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9382-0141","authenticated-orcid":true,"given":"Francesca","family":"Dominici","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Gill","sequence":"additional","affiliation":[{"name":"Yale School of Medicine , , , ,","place":["New Haven, Connecticut, United States, 06510"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Braun","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health , , , ,","place":["Boston, Massachusetts, United States, 02115"]},{"name":"Dana-Farber Cancer Institute , , , ,","place":["Boston, Massachusetts, United States, 02215"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Bell","sequence":"additional","affiliation":[{"name":"Yale University , , , ,","place":["New Haven, Connecticut, United States, 06511"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"4","key":"2026101215563399300_cit1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70235","article-title":"2025 Alzheimer\u2019s\ndisease facts and figures","volume":"21","author":"Alzheimer\u2019s Association.","year":"2025","journal-title":"Alzheimers Dement."},{"issue":"8","key":"2026101215563399300_cit2","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1002\/gps.5140","article-title":"Hospital readmission\nin persons with dementia: A systematic review","volume":"34","author":"Ma","year":"2019","journal-title":"Int. J. Geriatr Psychiatry."},{"issue":"1","key":"2026101215563399300_cit3","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1097\/QMH.0000000000000016","article-title":"Reducing Hospital Readmissions\nAmong Medicaid Patients:\nA Review of the Literature","volume":"23","author":"Regenstein","year":"2014","journal-title":"Qual Manag Health\nCa."},{"issue":"1","key":"2026101215563399300_cit4","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1186\/s12877-024-04905-6","article-title":"Determinants\nof hospital readmissions\nin older people with dementia: a narrative review","volume":"24","author":"Browne","year":"2024","journal-title":"BMC Geriatr."},{"issue":"3","key":"2026101215563399300_cit5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.2109","article-title":"Readmission\nRates and\nEpisode Costs for Alzheimer Disease and Related Dementias Across Hospitals\nin a Statewide Collaborative","volume":"6","author":"Kamdar","year":"2023","journal-title":"JAMA Netw Open."},{"issue":"2","key":"2026101215563399300_cit6","doi-asserted-by":"publisher","first-page":"e242","DOI":"10.1212\/WNL.0000000000201419","article-title":"Air Pollution\nand Incidence of Dementia:\nA Systematic Review and Meta-analysis","volume":"100","author":"Abolhasani","year":"2023","journal-title":"Neurology."},{"issue":"1","key":"2026101215563399300_cit7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/1476-069X-13-38","article-title":"A national case-crossover\nanalysis of the short-term effect of PM2.5 on hospitalizations and\nmortality in subjects with diabetes and neurological disorders","volume":"13","author":"Zanobetti","year":"2014","journal-title":"Environ. 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Health Rep."},{"issue":"2","key":"2026101215563399300_cit10","doi-asserted-by":"publisher","first-page":"e114","DOI":"10.1016\/S2542-5196(25)00001-4","article-title":"The impacts of air pollution\non mortality and hospital readmission among Medicare beneficiaries\nwith Alzheimer\u2019s disease and Alzheimer\u2019s disease-related\ndementias: a national retrospective cohort study in the USA","volume":"9","author":"Dong","year":"2025","journal-title":"Lancet Planet Health."},{"issue":"1","key":"2026101215563399300_cit11","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s40572-018-0179-y","article-title":"A Review of\nEpidemiologic Studies\non Greenness and Health: Updated Literature Through 2017","volume":"5","author":"Fong","year":"2018","journal-title":"Curr. 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Geriatr\nSoc."},{"key":"2026101215563399300_cit15","unstructured":"Centers for Medicare & Medicaid Services.\n          . Quality Measures Fact Sheet: Hospital-wide all-cause\nunplanned readmission measure (NQF #1789); 2019; https:\/\/www.cms.gov\/priorities\/innovation\/files\/fact-sheet\/bpciadvanced-fs-nqf1789.pdf."},{"issue":"18","key":"2026101215563399300_cit16","doi-asserted-by":"publisher","first-page":"11037","DOI":"10.1021\/acs.est.0c01791","article-title":"An Ensemble Learning Approach for Estimating\nHigh Spatiotemporal Resolution of Ground-Level Ozone in the Contiguous\nUnited States","volume":"54","author":"Requia","year":"2020","journal-title":"Environ. Sci. 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Climatol."},{"issue":"7633","key":"2026101215563399300_cit19","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1038\/nature20584","article-title":"High-resolution\nmapping of global surface water and its long-term changes","volume":"540","author":"Pekel","year":"2016","journal-title":"Nature."},{"key":"2026101215563399300_cit20","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2024.108739","article-title":"Associations of street-view\ngreenspace with Parkinson\u2019s disease hospitalizations in an\nopen cohort of elderly US Medicare beneficiaries","volume":"188","author":"Klompmaker","year":"2024","journal-title":"Environ. Int."},{"issue":"2","key":"2026101215563399300_cit21","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1289\/ehp.1306656","article-title":"Associations\nof PM2.5\nconstituents and sources with hospital admissions: analysis of four\ncounties in Connecticut and Massachusetts (USA) for persons \u2265\n65 years of age. Environ Health Perspect. 2014;122(2):138\u201344.\ndoi:10.1289\/ehp.1306656","volume":"122","author":"Bell","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"2026101215563399300_cit22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6258","article-title":"Short term exposure\nto fine particulate matter and hospital admission risks and costs\nin the Medicare population: time stratified, case crossover study","volume":"367","author":"Wei","year":"2019","journal-title":"BMJ."},{"key":"2026101215563399300_cit23","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.ahj.2022.02.015","article-title":"Short-term PM2.5 exposure\nand early-readmission risk: a retrospective cohort study in North\nCarolina heart failure patients","volume":"248","author":"Wyatt","year":"2022","journal-title":"Am. Heart J."},{"issue":"12","key":"2026101215563399300_cit24","doi-asserted-by":"publisher","first-page":"e041177","DOI":"10.1136\/bmjopen-2020-041177","article-title":"Association\nof short-term exposure\nto ambient PM2.5 with hospital admissions and 30-day readmissions\nin end-stage renal disease patients: population-based retrospective\ncohort study","volume":"10","author":"Wyatt","year":"2020","journal-title":"Bmj Open."},{"issue":"12","key":"2026101215563399300_cit25","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1136\/jech-2022-219676","article-title":"Short-term exposure\nto ambient air pollution and readmissions for heart failure among\n3660 post-discharge patients with hypertension in older Chinese adults","volume":"76","author":"Xu","year":"2022","journal-title":"J. Epidemiol Commun. H."},{"key":"2026101215563399300_cit26","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.chemosphere.2017.10.123","article-title":"Fine particulate air\npollution and hospital admissions and readmissions for acute myocardial\ninfarction in 26 Chinese cities","volume":"192","author":"Liu","year":"2018","journal-title":"Chemosphere."},{"issue":"11","key":"2026101215563399300_cit27","doi-asserted-by":"publisher","first-page":"766","DOI":"10.7326\/M17-1724","article-title":"Preventability of Early\nVersus Late Hospital Readmissions in a National Cohort of General\nMedicine Patients","volume":"168","author":"Graham","year":"2018","journal-title":"Ann. Int. Med."},{"key":"2026101215563399300_cit28","article-title":"Reducing Hospital\nReadmissions","volume-title":"StatPearls","author":"Dhaliwal","year":"2025"},{"issue":"1","key":"2026101215563399300_cit29","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12929-022-00799-x","article-title":"The pathogenic\neffects of particulate\nmatter on neurodegeneration: a review","volume":"29","author":"You","year":"2022","journal-title":"J. Biomed\nSci."},{"key":"2026101215563399300_cit30","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.neuro.2016.07.007","article-title":"Neurodegenerative and\nneurological disorders by small inhaled particles","volume":"56","author":"Heusinkveld","year":"2016","journal-title":"Neurotoxicology."},{"issue":"1","key":"2026101215563399300_cit31","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s11869-010-0101-8","article-title":"Particulate\nair pollution, systemic oxidative stress, inflammation, and atherosclerosis","volume":"4","author":"Araujo","year":"2011","journal-title":"Air Qual Atmos Health."},{"key":"2026101215563399300_cit32","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.envres.2019.04.019","article-title":"The influence of\ngreen space on the short-term effects\nof particulate matter on hospitalization in the US for 2000\u20132013","volume":"174","author":"Heo","year":"2019","journal-title":"Environ. Res."},{"issue":"9","key":"2026101215563399300_cit33","doi-asserted-by":"publisher","first-page":"4790","DOI":"10.3390\/ijerph18094790","article-title":"Associations between\nNature Exposure\nand Health: A Review of the Evidence","volume":"18","author":"Jimenez","year":"2021","journal-title":"Int. J.\nEnviron. Res. Public Health."},{"issue":"4647","key":"2026101215563399300_cit34","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1126\/science.6143402","article-title":"View through\na window may influence recovery from surgery","volume":"224","author":"Ulrich","year":"1984","journal-title":"Science."},{"key":"2026101215563399300_cit35","unstructured":"Centers for Medicare & Medicaid Services.\n          . Hospital Readmissions Reduction Program, Accessed September 30, 2025; https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/acute-inpatient-pps\/hospital-readmissions-reduction-program-hrrp."}],"container-title":["Environmental Health Perspectives"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.acs.org\/doi\/pdf\/10.1021\/EHP.6c00147","content-type":"application\/pdf","content-version":"vor","intended-application":"unspecified"},{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article-pdf\/134\/6\/707\/66848061\/ehp.6c00147.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article-pdf\/134\/6\/707\/66848061\/ehp.6c00147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:09:11Z","timestamp":1791835751000},"score":1,"resource":{"primary":{"URL":"https:\/\/pubs.acs.org\/evhpaz\/article\/134\/6\/707\/5275371\/PM2-5-and-30-Day-Readmission-in-Medicare"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,8,18]]},"published-print":{"date-parts":[[2026,10,6]]}},"URL":"https:\/\/doi.org\/10.1021\/ehp.6c00147","relation":{},"ISSN":["1552-9924"],"issn-type":[{"value":"1552-9924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}