Association Between Climate Extremes and Chronic Respiratory Diseases Among a Nationally Representative Sample of the U.S. Population

EPA Grant Number: F13B20312
Title: Association Between Climate Extremes and Chronic Respiratory Diseases Among a Nationally Representative Sample of the U.S. Population
Investigators: Romeo, Crystal Eloma
Institution: University of Maryland
EPA Project Officer: Lee, Sonja
Project Period: September 1, 2014 through September 1, 2016
Project Amount: $84,000
RFA: STAR Graduate Fellowships (2013) RFA Text |  Recipients Lists
Research Category: Fellowship - Environmental Science , Academic Fellowships


Due to the projected increase in extreme heat events and the likely rise in chronic diseases, such as asthma, it is necessary to identify the unknown effects of extreme heat events on the status of chronic human health. This issue is important because a small increase in the risk will have a significant effect on morbidity rates and healthcare costs; this will, in turn, worsen the public health burden that chronic diseases present. This project aims to develop empirical models—climate-extreme exposure metrics—that can quantify the risks that climate variability and change may create for individuals with respiratory diseases. The central hypothesis is that increased exposure to the extreme hot days contributes to the exacerbation of chronic respiratory diseases.


This study will examine the impact of long-term anomalous warming events—which may lead to changes in both biotic and anthropogenic air pollution—on asthma and emergency department visits for asthma, hay fever and chronic bronchitis. The aims are (1) to develop and validate a location-specific heat-related climate metric to characterize place-based exposure to anomalous warming events for use in exposure assessment and epidemiological studies on climate variability and change, using the years 1960–1989 as a baseline; and (2) to develop an empirical model of the heat-related climate metric (frequency of extreme hot days) that identifies the relationship between long-term exposure to anomalous warming events and chronic respiratory health outcomes. The working method is to link data by merging the heat-related climate metric to respondents in the National Health Interview Survey (NHIS). The linked data set will enable (1) an investigation of the relationship between climate variability and change on chronic respiratory diseases among the U.S. population and (2) an analysis of extreme hot-day exposure disparities among demo- graphic (i.e., children and older adults) and socioeconomic groups.

Expected Results:

The results of this study will provide a validated data set that has the monthly total number of extreme hot days for each county in the United States for the time period of 1960 to 2010. The linkage of the exposure metric to the NHIS for the years 1997–2010 should show (1) the association between heat and chronic respiratory diseases and (2) the variation in the distribution of exposure to extreme hot days. This will provide a national assessment of chronic respiratory diseases associated with anomalous warming events, based on observed data.

Potential to Further Environmental/Human Health Protection

In a changing climate, sustainable and resilient communities are vital for safeguarding the health of vulnerable populations, including children and older adults. The results of this study can substantiate the mobilization of community groups, coerce the policy-making process, and assist with the implementation of adaptation and mitigation tools to aid vulnerable and susceptible populations with combating the negative externalities of climate change. The statistical model will provide a predictive equation to enhance the robustness of climate prediction and economic models in quantifying the unaccounted impacts and costs of climate change. The methods developed from this study will be widely applicable for future studies linking other parameters, such as precipitation, to other diseases of concern.

Supplemental Keywords:

chronic respiratory diseases, climate change, exposure

Progress and Final Reports:

  • 2015
  • Final