{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:31:31Z","timestamp":1787031091519,"version":"build-2736575974"},"reference-count":49,"publisher":"Korean Society of Epidemiology","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea Environment Industry & Technology Institute"},{"DOI":"10.13039\/501100003562","name":"Ministry of Environment","doi-asserted-by":"publisher","award":["RS-2021-KE0001615"],"award-info":[{"award-number":["RS-2021-KE0001615"]}],"id":[{"id":"10.13039\/501100003562","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-epih.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol Health"],"abstract":"<jats:p>OBJECTIVES: This study aimed to evaluate the association between long-term exposure to particulate matter with an aerodynamic diameter &lt;2.5 \u03bcm (PM2.5) and cause-specific mortality among older adults in Korea, providing insights into the evolving public health burden in an aging society.METHODS: We analyzed national insurance claims data spanning 2010-2019. Modeled PM2.5 concentrations were assigned to participants according to their residential districts. We employed time-varying Cox proportional hazard models, using age as the time scale, adjusted for potential confounders. Six cause-specific mortalities were considered: ischemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD), acute lower respiratory infection (ALRI), lung cancer (LC), and type 2 diabetes mellitus (T2DM). Annual excess deaths attributable to long-term PM2.5 exposure were calculated.RESULTS: A total of 5,360,032 older adults were followed from 2010 to 2019. Hazard ratios (HRs) per 10 \u03bcg\/m3 increase in 12-month PM2.5 concentration were as follows: IHD, 1.068 (95% CI, 1.040 to 1.097); stroke, 1.023 (95% CI, 1.003 to 1.043); ALRI, 1.050 (95% CI, 1.026 to 1.076); COPD, 1.114 (95% CI, 1.072 to 1.157); T2DM, 1.046 (95% CI, 1.007 to 1.086); and LC, 0.972 (95% CI, 0.948 to 0.996). Excess deaths attributable to long-term PM2.5 exposure were estimated at 4,888 (95% CI, 2,304 to 7,323) in 2010 and 5,179 (95% CI, 2,585 to 7,648) in 2019.CONCLUSIONS: Although PM2.5 levels in Korea have shown a declining trend over the past decade, mortality among older adults associated with long-term PM2.5 exposure has not significantly decreased, likely due to the rapid aging of the population.<\/jats:p>","DOI":"10.4178\/epih.e2025028","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T22:18:45Z","timestamp":1748557125000},"page":"e2025028","update-policy":"https:\/\/doi.org\/10.4178\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mortality burden attributable to long-term exposure to fine particulate matter among older adults in 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