Final Report: Assessing Life-Shortening Associated with Exposure to Particulate Matter

EPA Grant Number: R827353C005
Subproject: this is subproject number 005 , 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: Assessing Life-Shortening Associated with Exposure to Particulate Matter
Investigators: Schwartz, Joel , Bateson, Thomas F , Coull, Brent , O'Neill, M. , Zanobetti, Antonella
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 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:

Theme II: Identifying Populations Susceptible to the Health Effects of Particulate Air Pollution

During the first two years of the particulate matter (PM) Center grant this project dealt primarily with harvesting. For subsequent years, the primary focus was on the development of statistical methods for investigating confounding, dose-response relationships and other particle health effects issues. The main objective of the harvesting research effort was to examine whether particles advance mortality by a few days (harvesting) or have a more profound impact on particle on public health. Another key issue in assessing the life-shortening effects of PM exposure is the question of dose-response. If there are thresholds for the effects of particles on deaths or hospital admissions then estimates of the public health effect will be overstated. To date, PM health effects studies suggest a no-threshold dose-response relationship. If in fact there are thresholds for the effects of particles on deaths or hospital admissions exist, however, estimated health effects may be overstated.

Summary/Accomplishments (Outputs/Outcomes):

Harvesting

We published several papers on harvesting. The first two used a smoothing approach to examine the association of PM over time with daily deaths in Boston (Schwartz, 2000c) and Chicago (Schwartz, 2001). Hospital admissions were also examined in the second paper. The main conclusions of those analyses were that particle effects on mortality and morbidity become stronger as average time increases, thus rejecting the harvesting hypothesis. We continued analyses investigating harvesting in 10 European cities by examining all cause, respiratory, and cardiovascular deaths, for all ages and stratifying by age groups. Our study confirmed that most of the effect of air pollution is not simply advanced by a few weeks and that effects persist for over a month after exposure. We found that the effect size estimate for PM10 doubles when we considered longer term effects for all mortality and cardiovascular mortality and becomes five times higher for respiratory mortality. We found similar effects when stratifying by age groups (Zanobetti, et al., 2003). In a related matter, we also clarified that control for influenza and other respiratory epidemics does not change the effect size estimates for PM effects on daily deaths (Braga, et al., 2000).

Dose-Response

We developed a new methodology that allows combining smoothed dose-response curves from multiple locations and demonstrated its effectiveness using simulation studies to examine this result. Subsequently, we applied this method to analyze daily deaths in 10 US cities. No deviation from linearity down to the lowest exposure concentrations was observed (Schwartz, 2000a). In addition, case-crossover studies were developed and applied to examine the association between PM2.5 concentrations and hospital admissions for myocardial infarctions (MIs) in Boston (Zanobetti and Schwartz, 2006).

We extended this methodology to incorporate heterogeneity in response across cities by developing a smoothed estimate that allows heterogeneity to vary by exposure level. This new methodology was then applied to eight cities in Spain (Schwartz, et al., 2001). We also applied this methodology to two-pollutant models and examined the sensitivity of the dose-response curve shape to the way season and weather were controlled. We found a significant linear association between daily deaths and black smoke. This association was little changed by variations in control for weather, season or SO2. For SO2, the association was implausible (inverted U shape) and disappeared after controlling for black smoke (Sunyer, et al., 2003). Finally, we have used hierarchical models to identify predictors of heterogeneity in nonlinear dose-response curves. This method was applied to examine the dose-response relationship between PM10 and hospital admissions for heart and lung disease. A manuscript is under preparation but has not been submitted for review.

Co-Pollutants

Additionally, we made important progress in assessing the effects of confounding by co-pollutants on the relation between particles and morbidity and mortality. We investigated the confounding effect of gaseous co-pollutants for both morbidity and mortality. We developed a hierarchical model to assess confounding and applied it to examine the association between PM10 and daily deaths (Schwartz, 2000b). The results of this analysis suggested that associations were not confounded by gaseous air pollutants. Further work has shown that the two-stage hierarchical modeling approach is more resistant to measurement error in the pollutants and confirmed that there is no association of gaseous co-pollutants with mortality in ten US cities (Schwartz and Coull, 2003).

Timing of the Effect

We found that the PM10 effects on myocardial infarction deaths occur on the same day, while for other cardiovascular deaths the lag is about a day. For respiratory deaths one- and two-day lags were observed. These patterns can be explained physiologically and can help to elucidate biological mechanisms (Braga, et al., 2001).

Statistical Methods

Finally, we demonstrated that it is possible to control for season and analyze mortality and morbidity using the case crossover approach (Bateson and Schwartz, 1999). We showed that there could be a selection bias and that it can be estimated and corrected (Bateson and Schwartz, 2001). Using this approach, we investigated the association between PM10 and daily deaths in Cook County, Illinois (Bateson and Schwartz, 2004).

After the first few years of the Center, the validity of using generalized additive models to assess PM health outcomes was under examination. Center investigators spent a great deal of time addressing this issue. Towards this end, we re-analyzed our 10-city mortality study, the Six City time series study, the Six City Source Apportionment Study, our hospital admissions studies and the long term distributed lag models from the Air Pollution on Health: A European Approach (APHEA) study. Additional work showed that then current approaches misestimated the standard errors of parametric terms when controlling for smooth functions. This raised questions about the entire approach. In addition to re-analyzing the data using different convergence criteria and natural splines, we developed alternative approaches including the penalized spline method (Schwartz, et al., 2002). The results of the re-analysis did not change substantially from previously reported results (Schwartz, et al., 2002).

Conclusions:

Through this work, we found that particle effects on mortality and morbidity become stronger as average time increases, thus rejecting the harvesting hypothesis. We also confirmed that most of the effect of air pollution is not simply advanced by a few weeks and that effects persist for more than a month after exposure. We also clarified that control for influenza and other respiratory epidemics does not change the effect size estimates for PM effects on daily deaths.

References:

Bateson T, Schwartz J. Control for seasonal variation and time trend in case crossover studies of acute effects of environmental exposures. Epidemiology 1999;10(5):539-544.

Bateson T, Schwartz J. Selection bias and confounding in case-crossover analyses of environmental time-series data. Epidemiology 2001;12(6):654-661.

Bateson T, Schwartz J. Who is sensitive to the effects of particulate air pollution on mortality? A case-crossover analysis of effect modifiers. Epidemiology 2004;15(2):143-149.

Braga AL, Zanobetti A, Schwartz J. Do respiratory epidemics confound the association between air pollution and daily deaths? European Respiratory Journal 2000;16:723-728.

Braga AL, Zanobetti A, Schwartz J. The lag structure between particulate air pollution and respiratory and cardiovascular deaths in ten US cities. Journal of Occupational and Environmental Medicine 2001;43(11):927-933.

Schwartz J. Assessing confounding, effect modification, and thresholds in the association between ambient particles and daily deaths. Environmental Health Perspectives 2000a;108(6):563-568.

Schwartz J. Daily deaths are associated with combustion particles rather than SO2 in Philadelphia. Occupational and Environmental Medicine 2000b;57(10):692-697.

Schwartz J. Harvesting and long term exposure effects in the relation between air pollution and mortality. American Journal of Epidemiology 2000c;151(5):440-448.

Schwartz, J. Is there harvesting in the association of airborne particles with daily deaths and hospital admissions? Epidemiology 2001;12(1):55-61.

Schwartz J, Ballester F, Saez M, Perez-Hoyos S, Bellido J, Cambra K, Arribas F, Canada A, Perez-Boillos MJ, Sunyer J. The concentration-response relation between air pollution and daily deaths. Environmental Health Perspectives 2001;109(10):1001-1006.

Schwartz J, Coull BA. Control for confounding in the presence of measurement error in hierarchical models. Biostatistics 2003;4(4):539-553.

Schwartz J, Laden F, Zanobetti A. The concentration-response relation between PM2.5 and daily deaths. Environmental Health Perspectives 2002;110(10):1025-1029.

Sunyer J, Atkinson R, Ballester F, Tertre AL, Ayres J, Forastiere F, Forsberg B, Vonk J, Bisanti L, Anderson R, Schwartz J, Katsouyanni K. Respiratory effects of sulphur dioxide: A hierarchical multicity analysis in the APHEA 2 study. Occupational and Environmental Medicine 2003;60(8):Art. No. e2.

Zanobetti A, Schwartz J. Air pollution and emergency admissions in Boston, MA. Journal of Epidemiology and Community Health 2006;60(10):890-895.

Zanobetti A, Schwartz J, Samoli E, Gryparis A, Touloumi G, Peacock J, Anderson RH, Tertre AL, Bobros J, Celko M, Goren A, Forsberg B, Michelozzi P, Rabczenko D, Perez Hoyos S, Wichmann HE, Katsouyanni K. The temporal pattern of respiratory and heart disease mortality in response to air pollution. Environmental Health Perspectives 2003;111(9):1188-1193.


Journal Articles on this Report : 22 Displayed | Download in RIS Format

Other subproject views: All 22 publications 22 publications in selected types All 22 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
    Exit
  • Abstract: Epidemiology-Abstract
    Exit
  • Other: Epidemiology-Full Text PDF
    Exit
  • Journal Article Bateson TF, Schwartz J. Who is sensitive to the effects of particulate air pollution on mortality? A case-crossover analysis of effect modifiers. Epidemiology 2004;15(2):143-149. R827353 (Final)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
    Exit
  • Abstract: Epidemiology-Abstract
    Exit
  • Other: Epidemiology-Full Text PDF
    Exit
  • Journal Article Braga ALF, Zanobetti A, Schwartz J. Do respiratory epidemics confound the association between air pollution and daily deaths? European Respiratory Journal 2000;16(4):723-728. R827353 (Final)
    R827353C005 (2000)
    R827353C005 (2002)
    R827353C005 (2003)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: European Respiratory Journal-Full Text PDF
    Exit
  • Abstract: European Respiratory Journal-Abstract
    Exit
  • Journal Article Braga ALF, Zanobetti A, Schwartz J. The lag structure between particulate air pollution and respiratory and cardiovascular deaths in 10 US cities. Journal of Occupational and Environmental Medicine 2001;43(11):927-933. R827353 (Final)
    R827353C005 (2001)
    R827353C005 (2002)
    R827353C005 (2003)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: ResearchGate-Full Text PDF
    Exit
  • Abstract: JOEM-Abstract
    Exit
  • Journal Article Dockery DW. Epidemiologic evidence of cardiovascular effects of particulate air pollution. Environmental Health Perspectives 2001;109(Suppl 4):483-486. R827353 (Final)
    R827353C005 (2002)
    R827353C005 (2003)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Journal Article Goodman PG, Dockery DW, Clancy L. Cause-specific mortality and the extended effects of particulate pollution and temperature exposure. Environmental Health Perspectives 2004;112(2):179-185. R827353 (Final)
    R827353C005 (2003)
    R827353C005 (Final)
    R827353C006 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Journal Article Medina-Ramon M, Zanobetti A, Schwartz J. The effect of ozone and PM10 on hospital admissions for pneumonia and chronic obstructive pulmonary disease:a national multicity study. American Journal of Epidemiology 2006;163(6):579-588. R827353 (Final)
    R827353C005 (Final)
    R832416 (2008)
  • Abstract from PubMed
  • Full-text: AJE-Full Text HTML
    Exit
  • Abstract: AJE-Abstract
    Exit
  • Other: AJE-Full Text PDF
    Exit
  • Journal Article Nikolov MC, Coull BA, Catalano PJ, Godleski JJ. An informative Bayesian structural equation model to assess source-specific health effects of air pollution. Biostatistics 2007;8(3):609-624. R827353 (Final)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Biostatistics-Full Text HTML
    Exit
  • Abstract: Biostatistics-Abstract
    Exit
  • Other: Biostatistics-Full Text PDF
    Exit
  • Journal Article O'Neill MS, Loomis D, Borja Aburto VH, Gold D, Hertz-Picciotto I, Castillejos M. Do associations between airborne particles and daily mortality in Mexico City differ by measurement method, region, or modeling strategy? Journal of Exposure Analysis and Environmental Epidemiology 2004;14(6):429-439. R827353 (Final)
    R827353C005 (2003)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Nature-Full Text PDF
    Exit
  • Abstract: Nature-Abstract & Full Text HTML
    Exit
  • Other: Research Gate-Abstract & Full Text
    Exit
  • Journal Article Schwartz J. Harvesting and long term exposure effects in the relation between air pollution and mortality. American Journal of Epidemiology 2000;151(5):440-448. R827353 (Final)
    R827353C005 (2000)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: AJE-Full Text PDF
    Exit
  • Abstract: AJE-Abstract
    Exit
  • Journal Article Schwartz J, Zanobetti A. Using meta-smoothing to estimate dose-response trends across multiple studies, with application to air pollution and daily death. Epidemiology 2000;11(6):666-672. R827353 (Final)
    R827353C005 (2000)
    R827353C005 (2002)
    R827353C005 (2003)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
    Exit
  • Abstract: Epidemiology-Abstract & PDF Link
    Exit
  • Other: Epidemiology-Full Text PDF
    Exit
  • Journal Article Schwartz J. Daily deaths are associated with combustion particles rather than SO2 in Philadelphia. Occupational and Environmental Medicine 2000;57(10):692-697. R827353 (Final)
    R827353C005 (2000)
    R827353C005 (2001)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: OEM-Full Text HTML
    Exit
  • Abstract: OEM-Abstract
    Exit
  • Other: OEM-Full Text PDF
    Exit
  • Journal Article Schwartz J. Is there harvesting in the association of airborne particles with daily deaths and hospital admissions? Epidemiology 2001;12(1):55-61. R827353 (Final)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
    Exit
  • Abstract: Epidemiology-Abstract
    Exit
  • Other: Epidemiology-Full Text PDF
    Exit
  • Journal Article Schwartz J, Ballester F, Saez M, Perez-Hoyos S, Bellido J, Cambra K, Arribas F, Canada A, Perez-Boillos MJ, Sunyer J. The concentration-response relation between air pollution and daily deaths. Environmental Health Perspectives 2001;109(10):1001-1006. R827353 (Final)
    R827353C005 (2000)
    R827353C005 (2002)
    R827353C005 (2003)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Journal Article Schwartz J, Laden F, Zanobetti A. The concentration-response relation between PM2.5 and daily deaths. Environmental Health Perspectives 2002;110(10):1025-1029. R827353 (Final)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Journal Article Schwartz J, Coull BA. Control for confounding in the presence of measurement error in hierarchical models. Biostatistics 2003;4(4):539-553. R827353 (Final)
    R827353C002 (Final)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Biostatistics-Full Text PDF
    Exit
  • Abstract: Biostatistics-Abstract
    Exit
  • Journal Article Schwartz J. The effects of particulate air pollution on daily deaths:a multi-city case crossover analysis. Occupational and Environmental Medicine 2004;61(12):956-961. R827353 (Final)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: OEM-Full Text HTML
    Exit
  • Abstract: OEM-Abstract
    Exit
  • Other: OEM-Full Text PDF
    Exit
  • Journal Article Schwartz J. How sensitive is the association between ozone and daily deaths to control for temperature? American Journal of Respiratory and Critical Care Medicine 2005;171(6):627-631. R827353 (Final)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: AJRCCM-Full Text HTML
    Exit
  • Abstract: AJRCCM-Abstract
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  • Other: AJRCCM-Full Text PDF
    Exit
  • Journal Article Sunyer J, Atkinson R, Ballester F, Le Tertre A, Ayres JG, Forastiere F, Forsberg B, Vonk JM, Bisanti L, Anderson RH, Schwartz J, Katsouyanni K. Respiratory effects of sulphur dioxide:a hierarchical multicity analysis in the APHEA 2 study. Occupational and Environmental Medicine 2003;60(8):e2. R827353 (Final)
    R827353C005 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: OEM-Full Text HTML
    Exit
  • Abstract: OEM-Abstract
    Exit
  • Other: OEM-Full Text PDF
    Exit
  • Journal Article Zanobetti A, Schwartz J. Cardiovascular damage by airborne particles:are diabetics more susceptible? Epidemiology 2002;13(5):588-592. R827353 (Final)
    R827353C004 (2001)
    R827353C004 (2002)
    R827353C004 (2003)
    R827353C004 (Final)
    R827353C005 (2003)
    R827353C005 (Final)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
    Exit
  • Abstract: Epidemiology-Abstract
    Exit
  • Other: Epidemiology-Full Text PDF
    Exit
  • Journal Article Zanobetti A, Schwartz J. Air pollution and emergency admissions in Boston, MA. Journal of Epidemiology & Community Health 2006;60(10):890-895. R827353 (Final)
    R827353C004 (Final)
    R827353C005 (Final)
    R832416 (2008)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Abstract: JECH-Abstract
    Exit
  • Journal Article Zeka A, Zanobetti A, Schwartz J. Short term effects of particulate matter on cause specific mortality:effects of lags and modification by city characteristics. Occupational and Environmental Medicine 2005;62(10):718-725. R827353 (Final)
    R827353C005 (Final)
    R832416 (2008)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: OEM-Full Text HTML
    Exit
  • Abstract: OEM-Abstract
    Exit
  • Other: OEM-Full Text PDF
    Exit
  • Supplemental Keywords:

    RFA, Health, Scientific Discipline, Air, Geographic Area, particulate matter, Toxicology, Environmental Chemistry, Epidemiology, State, Risk Assessments, Microbiology, Susceptibility/Sensitive Population/Genetic Susceptibility, Environmental Microbiology, Environmental Monitoring, genetic susceptability, Atmospheric Sciences, Molecular Biology/Genetics, Biology, Environmental Engineering, ambient air quality, interindividual variability, molecular epidemiology, particulates, risk assessment, sensitive populations, chemical exposure, cardiopulmonary responses, health risks, human health effects, indoor exposure, ambient air monitoring, ambient measurement methods, exposure, pulmonary disease, Utah (UT), developmental effects, epidemelogy, respiratory disease, air pollution, children, Human Health Risk Assessment, Massachusetts (MA), particle exposure, lung cancer, biological mechanism , pre-existing conditions, cardiopulmonary response, human exposure, inhalation, pulmonary, Illinois (IL), particulate exposure, ambient particle health effects, mortality studies, elderly, Connecticut (CT), human susceptibility, inhalation toxicology, indoor air quality, inhaled particles, air quality, cardiovascular disease, dosimetry, human health risk, respiratory, genetic susceptibility

    Relevant Websites:

    http://www.hsph.harvard.edu/epacenter/epa_center_99-05/index.html Exit

    Progress and Final Reports:

    Original Abstract
  • 1999 Progress Report
  • 2000 Progress Report
  • 2001 Progress Report
  • 2002 Progress Report
  • 2003 Progress Report
  • 2004

  • 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