2004 Progress Report: Examining Conditions That Predispose Towards Acute Adverse Effects of Particulate Exposures

EPA Grant Number: R827353C004
Subproject: this is subproject number 004 , established and managed by the Center Director under grant R827353
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Harvard Particle Center
Center Director: Koutrakis, Petros
Title: Examining Conditions That Predispose Towards Acute Adverse Effects of Particulate Exposures
Investigators: Schwartz, Joel
Current Investigators: Schwartz, Joel , Zanobetti, Antonella , Wellenius, Gregory , O'Neill, M.
Institution: Harvard T.H. Chan School of Public Health , Harvard University
EPA Project Officer: Chung, Serena
Project Period: June 1, 1999 through May 31, 2005 (Extended to May 31, 2006)
Project Period Covered by this Report: June 1, 2004 through May 31, 2005
Project Amount: Refer to main center abstract for funding details.
RFA: Airborne Particulate Matter (PM) Centers (1999) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Particulate Matter , Air

Objective:

During year six, we continued to work on our major themes of addressing questions of confounding, making methodological advances, and addressing susceptibility through three projects. The results of two of these projects are summarized below and the third one is summarized in the report for R827353C006.

Progress Summary:

Investigation of Factors Influencing PM mortality/Morbidity Relationships

We have investigated factors influencing PM mortality and morbidity relationships in several ways. First, we have examined the association of air pollution with more specific responses than have generally been examined. For example, we have multi-city papers examining the association of PM10 with hospital admissions for congestive heart failure (Wellenius, Schwartz, and Mittleman, 2005, American Journal of Epidemiology ; Wellenius, Schwartz, and Mittelman, 2005, American Journal of Cardiology), stroke (Wellenius, Schwartz, and Mittelman , 200 5, Stroke), and myocardial infarction (Zanobetti and Schwartz, 2005). Further, since the studies were case crossover analyses of individual data, rather than count data, we were able to examine the role of other pre-existing medical conditions (e.g., diabetes, COPD) as modifiers of those associations in all of these studies, providing further evidence of who is susceptible to the effects of particle exposures. For example, persons with COPD or pneumonia were more susceptible to the effects of PM10 triggering an MI. We have also examined the association of daily mortality for more specific causes of death, and examined factors that modify that association (Zeka, Zanobetti, and Schwartz, 2005 ).

In another study, we examined the effects of particulate air pollution on subjects with type II diabetes, and found an effect of both traffic particles and sulfate particles on flow mediated dilation, a measure of the function of the endothelial layer of the arteries, and a risk factor for atherosclerosis (O’Neill, Veves, Zanobetti, et al., 2005 ).

Effects of Exposure and Confounding on Air Pollution Epidemiology

The objective of this research project is to examine the major potential confounding for the short-term effects of air pollution, temperature, and other gaseous pollutants. The major potential confounders for the short-term effects of air pollution are temperature and other gaseous air pollutants. To examine their role as confounders, we first need to understand better what their real association with the health outcomes of concern are. In addition, we have made methodological advancements that allow us to control for confounding without fully understanding the nature of the association between the potential confounders and health outcomes.

Specifically, we have spent a good deal of time examining the association of temperature with mortality and hospital admissions, as temperature seems the most reasonable potential confounder. We have examined, for the first time, the association of temperature with cardiovascular hospital admissions in a large multi-city study (Schwartz, Samet, and Patz, 2004). This association differed greatly from that seen for mortality, with admissions increasing monotonically with increasing temperature. We have also demonstrated that there are social and racial gradients in the temperature related mortality risks that are much larger than those seen for air pollution, suggesting that the air pollution effects are not due to confounding, since they show a different pattern (O’Neill, Zanobetti, et al., 2005; O’Neill, Hajat, et al., 2005). Finally, we have begun to examine the role of medical condition as a susceptibility factor in temperature related deaths (Schwartz, 2005, Epidemiology).

Moving on to the issue of confounding, we have used the case-crossover approach and matched control days to have the same temperature as the day for each death (Schwartz, 2004, Occupational and Environmental Medicine). Since the case and control days are identical on temperature, it cannot be a confounder. We found that this approach yielded the same risk estimates as when control days were not matched on temperature, and temperature was controlled with regression splines. This provides considerable reassurance that the results for PM are not due to confounding by temperature. In addition, the same approach was applied to examining the ozone-mortality association in a large multi-city study, with similar results.

With regard to confounding by gaseous air pollutants, we used the same approach of choosing matched control days. Control days were matched either on the level of O3, SO2, NO2, or CO in a case-crossover study, and the effect of PM10 remained in all cases (Schwartz, 2004, Environmental Health Perspectives). Because this approach, unlike the NMMAPS approach, is not sensitive to how the other pollutant was controlled (linear, nonlinear, what form, etc.), it provides strong evidence of an independent effect.

In a last examination of confounding, we have used a recently developed hierarchical method to control for confounders in the presence of measurement error (Schwartz and Coull, 2003) to re-examine the NMMAPS mortality study (Zeka and Schwartz, 2004). We found that after controlling for measurement error, PM was still associated with daily deaths, independent of the other pollutants.


Journal Articles on this Report : 9 Displayed | Download in RIS Format

Other subproject views: All 34 publications 34 publications in selected types All 33 journal articles
Other center views: All 200 publications 198 publications in selected types All 197 journal articles
Type Citation Sub Project Document Sources
Journal Article Bateson TF, Schwartz J. Selection bias and confounding in case-crossover analyses of environmental time-series data. Epidemiology 2001;12(6):654-661. R827353 (Final)
R827353C004 (2002)
R827353C004 (2003)
R827353C004 (2004)
R827353C004 (Final)
R827353C005 (2001)
R827353C005 (2002)
R827353C005 (2003)
R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
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  • Abstract: Epidemiology-Abstract
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  • Other: Epidemiology-Full Text PDF
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  • Journal Article Braga ALF, Zanobetti A, Schwartz J. The time course of weather-related deaths. Epidemiology 2001;12(6):662-667. R827353 (Final)
    R827353C004 (2002)
    R827353C004 (2003)
    R827353C004 (2004)
    R827353C004 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
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  • Abstract: Epidemiology-Abstract
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  • Other: Epidemiology-Full Text PDF
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  • Journal Article O'Neill MS, Veves A, Zanobetti A, Sarnat JA, Gold DR, Economides PA, Horton ES, Schwartz J. Diabetes enhances vulnerability to particulate air pollution-associated impairment in vascular reactivity and endothelial function. Circulation 2005;111(22):2913-2920. R827353 (Final)
    R827353C004 (2003)
    R827353C004 (2004)
    R827353C004 (Final)
  • Abstract from PubMed
  • Full-text: Circulation-Full Text HTML
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  • Abstract: Circulation-Abstract
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  • Journal Article O'Neill MS, Hajat S, Zanobetti A, Ramirez-Aguilar M, Schwartz J. Impact of control for air pollution and respiratory epidemics on the estimated associations of temperature and daily mortality. International Journal of Biometeorology 2005;50(2):121-129. R827353 (Final)
    R827353C004 (2003)
    R827353C004 (2004)
    R827353C004 (Final)
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  • Abstract: SpringerLink-Abstract
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  • Journal Article Schwartz J. Who is sensitive to extremes of temperature? A case-only analysis. Epidemiology 2005;16(1):67-72. R827353 (Final)
    R827353C004 (2004)
    R827353C004 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
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  • Abstract: Epidemiology-Abstract
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  • Journal Article Wellenius GA, Schwartz J, Mittleman MA. Air pollution and hospital admissions for ischemic and hemorrhagic stroke among Medicare beneficiaries. Stroke 2005;36(12):2549-2553. R827353 (Final)
    R827353C004 (2004)
    R827353C004 (Final)
  • Abstract from PubMed
  • Full-text: AHA-Full Text HTML
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  • Abstract: AHA_Abstract
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  • Journal Article Wellenius GA, Bateson TF, Mittleman MA, Schwartz J. Particulate air pollution and the rate of hospitalization for congestive heart failure among Medicare beneficiaries in Pittsburgh, Pennsylvania. American Journal of Epidemiology 2005;161(11):1030-1036. R827353 (Final)
    R827353C004 (2004)
    R827353C004 (Final)
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  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: AJE-Full Text HTML
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  • Abstract: AJE-Abstract
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  • Journal Article Wellenius GA, Schwartz J, Mittleman MA. Particulate air pollution and hospital admissions for congestive heart failure in seven United States cities. The American Journal of Cardiology 2006;97(3):404-408. R827353 (Final)
    R827353C004 (2004)
    R827353C004 (Final)
    R832416 (2008)
  • Abstract from PubMed
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  • Abstract: AJC-Abstract
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  • Other: ScienceDirect-Abstract
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  • Journal Article Zanobetti A, Schwartz J. The effect of particulate air pollution on emergency admissions for myocardial infarction:a multicity case-crossover analysis. Environmental Health Perspectives 2005;113(8):978-982. R827353 (Final)
    R827353C004 (2004)
    R827353C004 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Supplemental Keywords:

    exposure, health effects, susceptibility, metals, public policy, biology, engineering, epidemiology, toxicology, environmental chemistry, monitoring, air pollutants, air pollution, air quality, ambient air, ambient air monitoring, ambient air quality, ambient measurement methods, ambient monitoring, ambient particle health effects, ambient particles, animal inhalation study, assessment of exposure, biological mechanism, biological response, cardiopulmonary, cardiopulmonary response, cardiovascular disease, chemical exposure, children, developmental effects, dosimetry, environmental health hazard, exposure and effects, genetic susceptibility, health risks, human exposure, human health, human health effects, human health risk, human susceptibility, indoor air quality, indoor exposure, inhalation, inhalation toxicology, inhaled particles, lead, measurement methods, particle exposure, particulate exposure, particulates, pulmonary, pulmonary disease, respiratory, respiratory disease, risk assessment, sensitive populations, stratospheric ozone,, RFA, Health, Scientific Discipline, Air, Geographic Area, particulate matter, Toxicology, air toxics, Environmental Chemistry, Epidemiology, State, Risk Assessments, Microbiology, Susceptibility/Sensitive Population/Genetic Susceptibility, Environmental Microbiology, Environmental Monitoring, Children's Health, genetic susceptability, tropospheric ozone, Atmospheric Sciences, Molecular Biology/Genetics, Biology, Environmental Engineering, ambient air quality, health effects, interindividual variability, molecular epidemiology, monitoring, particulates, risk assessment, sensitive populations, chemical exposure, air pollutants, cardiopulmonary responses, health risks, human health effects, indoor exposure, lung, stratospheric ozone, ambient air monitoring, exposure and effects, ambient air, ambient measurement methods, exposure, pulmonary disease, Utah (UT), developmental effects, epidemelogy, biological response, respiratory disease, air pollution, ambient monitoring, children, Human Health Risk Assessment, Massachusetts (MA), particle exposure, lung cancer, biological mechanism , cardiopulmonary response, human exposure, inhalation, pulmonary, susceptibility, Illinois (IL), particulate exposure, assessment of exposure, ambient particle health effects, elderly, indoor air, inhaled, Connecticut (CT), atmospheric monitoring, epidemeology, human susceptibility, environmental health hazard, inhalation toxicology, cardiopulmonary, indoor air quality, inhaled particles, human health, air quality, cardiovascular disease, dosimetry, human health risk, respiratory

    Progress and Final Reports:

    Original Abstract
  • 1999 Progress Report
  • 2000 Progress Report
  • 2001 Progress Report
  • 2002 Progress Report
  • 2003 Progress Report
  • Final Report

  • Main Center Abstract and Reports:

    R827353    Harvard Particle Center

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R827353C001 Assessing Human Exposures to Particulate and Gaseous Air Pollutants
    R827353C002 Quantifying Exposure Error and its Effect on Epidemiological Studies
    R827353C003 St. Louis Bus, Steubenville and Atlanta Studies
    R827353C004 Examining Conditions That Predispose Towards Acute Adverse Effects of Particulate Exposures
    R827353C005 Assessing Life-Shortening Associated with Exposure to Particulate Matter
    R827353C006 Investigating Chronic Effects of Exposure to Particulate Matter
    R827353C007 Determining the Effects of Particle Characteristics on Respiratory Health of Children
    R827353C008 Differentiating the Roles of Particle Size, Particle Composition, and Gaseous Co-Pollutants on Cardiac Ischemia
    R827353C009 Assessing Deposition of Ambient Particles in the Lung
    R827353C010 Relating Changes in Blood Viscosity, Other Clotting Parameters, Heart Rate, and Heart Rate Variability to Particulate and Criteria Gas Exposures
    R827353C011 Studies of Oxidant Mechanisms
    R827353C012 Modeling Relationships Between Mobile Source Particle Emissions and Population Exposures
    R827353C013 Toxicological Evaluation of Realistic Emissions of Source Aerosols (TERESA) Study
    R827353C014 Identifying the Physical and Chemical Properties of Particulate Matter Responsible for the Observed Adverse Health Effects
    R827353C015 Research Coordination Core
    R827353C016 Analytical and Facilities Core
    R827353C017 Technology Development and Transfer Core