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Short term exposure to fine particulate matter and hospital admission risks and costs in the Medicare population: time stratified, case crossover study

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6258 (Published 27 November 2019) Cite this as: BMJ 2019;367:l6258

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Rapid Response:

Re: Short term exposure to fine particulate matter and hospital admission risks and costs in the Medicare population: time stratified, case crossover study

Dear Editor,

At least 10% of the 2000 - 2012 Medicare population ( 95,277,169) must have been smokers who inhale 10,000 to 40,000 microgrammes per cubic metre of PM2.5 in a few minutes per cigarette (1). Compare this to a non-smoker who breathes in 1 cubic metre of air per hour, which equates to 24 cubic metres over 24 hours. Even an extra 24 microgrammes of PM2.5 is tiny compared to PM2.5 inhaled by smokers from 1 cigarette. If short term exposure to PM2.5 is linked to deaths as claimed, shouldn't there gave been over 9.5 million deaths out of the 95 million Medicare population due to the short term inhalation of PM2.5 directly from cigarette smoke?

(1) National Research Council. Environmental tobacco smoke: measuring exposures and assessing health effects. Washington, D.C.: National Academy Press; 1986.

Competing interests: No competing interests

08 December 2019
Paul M Biggs
Retired Cancer Researcher
University of Birmingham, UK
Tamworth, Stafforshire, B77