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2003 Progress Report: Chronic and Acute Exposure to Ambient Fine Particulate Matter and Other Air Pollutants: National Cohort Studies of Mortality and Morbidity

EPA Grant Number: R830548
Title: Chronic and Acute Exposure to Ambient Fine Particulate Matter and Other Air Pollutants: National Cohort Studies of Mortality and Morbidity
Investigators: Samet, Jonathan M. , Dominici, Francesca , Geyh, Alison , Louis, Thomas A. , McDermott, Aidan , Parent, Stephen T. , Wyant, Timothy , Zeger, Scott L.
Current Investigators: Samet, Jonathan M.
Institution: Johns Hopkins University , Decipher , Health Systems Innovations
EPA Project Officer: Glenn, Barbara
Project Period: February 1, 2003 through January 31, 2006 (Extended to January 31, 2007)
Project Period Covered by this Report: February 1, 2003 through January 31, 2004
Project Amount: $1,033,646
RFA: Epidemiologic Research on Health Effects of Long-Term Exposure to Ambient Particulate Matter and Other Air Pollutants (2002)
Research Category: Health Effects , Particulate Matter

Description:

Objective:

The overall objective of this research project is to address a key uncertainty in the evidence on the effects of particulate matter (PM) on public health: the effects of longer term exposure to airborne PM, including PM2.5, on morbidity and mortality. The specific objectives of this research project are to use large, existing cohorts established by federal agencies to:

  1. test the hypothesis that long-term exposure to PM increases mortality and morbidity;
  2. explore whether any effect of PM varies with levels of other pollutants;
  3. and compare risks of exposure to PM in persons with and without underlying heart and lung disease.

Because the large cohorts include daily data, we will apply methods for time-series analysis to compare the effect of PM on time scales ranging from daily to yearly. We will explore spatial variation of the effects of PM and other pollutants. We also will establish a protocol for ongoing use of these studies for tracking the public health risks of air pollution.

Progress Summary:

The focus of analysis will be the longitudinal data in the National Medicare Cohort (NMC), comprising more than 27 million Medicare participants living within 10 miles of a PM monitor and followed for hospitalization and death. For a 5 percent sample, outpatient visits are available. We have data for 1999-2002, with approximately 800,000 deaths annually. We will use hospitalization data to construct comorbidity measures. A separate smaller survey, the Medicare Current Beneficiary Survey (MCBS), provides information on a large number of potential confounding factors. We also will explore the use of the Veterans Health Study Cohort, which includes 900,000 persons. Data on hospitalization and mortality from these cohorts will be combined with weather data and the air monitoring data routinely collected by the U.S. Environmental Protection Agency (EPA). During the 3 years of this research project, we will obtain data and create the analytic database, address methodological issues related to imputation of potential confounding factors, and estimate the acute and chronic effects of PM2.5 and other pollutants on morbidity and mortality, including characterizing effects on differing time scales and regions of the country.

We have identified epidemiologic cohorts that can provide reasonably precise estimates of the health risks posed by PM2.5 and other pollutants. The cohorts will provide sufficient events to directly address risks of PM2.5 without using surrogate indicators. The data will offer insights into cardiac and respiratory comorbidity as a determinant of susceptibility, as well as insights into the differing magnitudes of risks found in the time series and cohort studies of PM. The findings will advance our understanding of the public health consequences of air pollution and support the development of more certain risk models for air pollution and health.

During Year 1 of the project, emphasis has been placed on obtaining the above data sets, integrating them into an analytic file, and beginning to develop the methods for data analysis. We have obtained the Medicare data, including the full Part B data set, the 5 percent sample data for Part A, and the MCBS data. This initial phase of the study is now coming to completion, and we have begun exploratory analyses of the NMC study data to validate the database and the planned statistical approach.

Future Activities:

We will begin to address study hypotheses using this extraordinarily rich data resource. As noted above, emphasis to date has been placed on obtaining substantial raw data and developing analytical files. The scope of the cohort shows the potential of the study population for addressing the overall goals of the original Science To Achieve Results (STAR) grant application, and for characterizing the short-term and long-term effects of PM on morbidity and mortality. The findings should prove informative to the U.S. EPA as it continues to develop the base of scientific evidence needed for support of the National Ambient Air Quality Standard for PM. The general approach of using the Centers for Medicare and Medicaid Services data may prove to be a useful model for investigating the effects of other environmental agents on elderly and other vulnerable populations.

Journal Articles:

No journal articles submitted with this report: View all 1 publications for this project

Supplemental Keywords:

ambient air, health effects, air, human health, health, epidemiology, susceptibility, sensitive population, particulate matter, PM, acute health effects, PM2.5, acute cardiovascular effects, acute exposure, air pollution, air quality, cardiovascular disease, chronic health effects, fine particles, human exposure, inhaled pollutants, long-term exposure, morbidity, mortality, particulate exposure, susceptible subpopulations, time-series analysis, , HUMAN HEALTH, Air, Scientific Discipline, Health, RFA, PHYSICAL ASPECTS, Susceptibility/Sensitive Population/Genetic Susceptibility, Risk Assessments, Health Risk Assessment, Physical Processes, Epidemiology, air toxics, particulate matter, Environmental Chemistry, Exposure, cardiopulmonary, environmental hazard exposures, airborne urban contaminants, acute exposure, Acute health effects, cardiovascular disease, mortality, air contaminant exposure, co-pollutants, cardiac arrest, air quality, cardiopulmonary response, cardiotoxicity, fine particles, cardiopulmonary responses, human health risk, lung inflammation, toxics, concentrated particulate matter, acute cardiovascular effects, chronic health effects, PM 2.5, sensitive populations, acute lung injury, air pollution, inhaled, atmospheric particulate matter, National Cohort Studies, copollutant exposures, susceptible subpopulations, airway epithelial cells, long term exposure, human susceptibility, time series analysis, human exposure, morbidity, particulate exposure
Relevant Websites:

http://www.biostat.jhsph.edu/bstproj/ebeg/data.php exit EPA

http://www.ihapss.jhsph.edu exit EPA

Progress and Final Reports:
Original Abstract
2004 Progress Report
2005 Progress Report
Final Report

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The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.

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