LAUSR

Abstract Fine particulate matter (PM2.5) in New York State declined significantly between 2005 and 2016. Fewer hospitalizations and emergency department (ED) visits for cardiovascular diseases (CVD), respiratory diseases (RD), and respiratory infections (RI) were also observed. However, increased per unit mass toxicity of the remaining PM2.5 was observed. In this study, the changes in hospitalizations and ED visits have been assessed by comparing the PM2.5 and source specific PM2.5 excess risk (ER) relationships between 2005-2007 and 2014–2016 yielded reductions of ~27,000, 2600, and 4251 hospitalizations per year for CVD, RD, and RI, and charge savings of ~613, 41, and 41 million dollars, respectively. However, period specific ER values estimated lower health and cost benefits. For some diseases, hospitalizations increased with increased healthcare costs. Using the whole-period source-specific PM2.5 ER values, the number of hospitalizations decreased by ~13,500 and ~19,000 for CVD and RD but increased by ~800 for RI. Larger period specific ER values for RD shifted from net decreases to net increases in ED visits. Costs followed the numbers of hospitalizations and ED visits and produced increased charges of ~$284 million. County average costs for disease specific hospitalizations and ED visits were used with county specific ER values to estimate those costs. There were increased ED visit costs for some health outcomes. Thus, further action is required to address changes in composition as well as further reductions in concentrations will be needed to address changes in composition and to provide additional public health gains.