2000 Progress Report: Health Effects

EPA Grant Number: R827355C002
Subproject: this is subproject number 002 , established and managed by the Center Director under grant R827355
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Airborne PM - Northwest Research Center for Particulate Air Pollution and Health
Center Director: Koenig, Jane Q.
Title: Health Effects
Investigators: Koenig, Jane Q. , Budge, Matt , Jansen, Karen , Kaufman, Joel D. , Larson, Timothy V. , Liu, Sally , Lumley, Thomas , Mar, Therese , Schildcrout, Jonathan , Sheppard, Lianne (Elizabeth) A. , Slaughter, C. W. , Sullivan, Jeff , Trenga, Carol
Current Investigators: Koenig, Jane Q. , Allen, Ryan , Jansen, Karen , Larson, Timothy V. , Lippmann, Morton , Lumley, Thomas , Mar, Therese , Sheppard, Lianne (Elizabeth) A.
Institution: University of Washington
EPA Project Officer: Chung, Serena
Project Period: June 1, 1999 through May 31, 2004 (Extended to May 31, 2006)
Project Period Covered by this Report: June 1, 2000 through May 31, 2001
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


This research project is a Health Effect Panel Study that involves comprehensive health monitoring of one healthy and three susceptible subpopulations in Seattle and possibly other cities. The susceptible individuals proposed for study are adults who are 65 years of age or older and are either healthy, have chronic obstructive pulmonary disease (COPD) or cardiovascular disease, or children with asthma. The health endpoints to be measured in adult subjects are peak flow, pulse rate, pulse oximetry, blood pressure (BP), heart rate variability, as well as symptoms and medication use. The health endpoints to be measured in the children with asthma are pulmonary function, symptoms, medication use, and exhaled nitric oxide. Personal exposure measurements necessary for associating the health effects with air pollutants will be collected on study participants in Project 2b.

Progress Summary:

The goals for Year 2 from Project 2a, Health Effects, were as follows:

  1. Measure cardiopulmonary health endpoints in a panel of subjects aged 50 years or older enrolled in the Exposure Assessment evaluations in Project 2b.

  2. Measure lung function and exhaled nitric oxide (NO) in a panel of children with asthma enrolled in the Exposure Assessment evaluations in Project 2b.

  3. Conduct a controlled exposure evaluation of nitrogen dioxide (NO2) effects in former healthy panel subjects to further understand the role of co-pollutants.

  4. Evaluate air pollution/asthma aggravation relationships in existing cohorts of children with asthma.

We have accomplished these goals with considerable success. Our progress is described below.

1. Cardiovascular Subjects

Twenty-five subjects with varying degrees of cardiovascular disease, including several with congestive heart failure, enrolled in the Exposure Assessment/Health Effects Study in Year 2. These subjects completed a 10-day monitoring session during an 8-month interval, starting on September 25, 2000, and continuing to May 26, 2001. This period encompasses the winter heating season. Ten of our subjects repeated the 10-day monitoring session during this period. Health data collected from the subjects was identical to Year 1 and included: lung function (VM+, PFM), BP, arterial oxygen saturation, heart rate variability, blood draw, diet diary, symptom ratings, and medication use.

2. Subjects With Asthma

Nineteen children with asthma, ages 7 to 12, enrolled in the Exposure Assessment/Health Study in Year 2. These subjects completed a 10-day monitoring session from November 27, 2000, to May 26, 2001. Thirteen of the children re-enrolled and completed a second session. Health endpoints measured in the pediatric subjects were: lung function (Spirometry using the MicroDL), exhaled NO, symptom ratings, diet diary, and medication use. Exhaled NO was a new measurement for our laboratory. The Koenig laboratory spent several months devising an appropriate offline protocol for collection of exhaled breath for NO analysis both in the laboratory and in the field.

We have not made a final comparison of the associations between the health endpoints and PM/other pollutants because the data are currently being reviewed and inspected for errors. The results are as follows:


? Subjects with COPD had a 37 percent increase in reported ankle swelling for every 10 :g/m3 increase in central site PM2.5 exposure (95 percent CI=1.03,1.83; p=0.03) in a model with a 1-day lag (0 lag: OR=1.34, 95 percent CI=0.96,1.87; p=0.09).

? These findings in a small panel study indicate that elderly individuals, both with and without COPD, are at risk of experiencing clinically significant effects from a 10 mg/m3 increase in PM2.5 exposure.


? Preliminary analyses document a 25.1 percent decline in the log of the median high frequency power for a 10 :g/m3 increase in PM2.5 in participants with cardiac disease not on medications after adjusting for NO2.

? In our small sample analyzed, cardiovascular disease patients on cardiac medications have a preservation of HF power with increasing exposure to PM2.5.

3. Controlled Exposure Study (Primarily Funded With Non-PM Center Funds)

This study is considered a followup of the Year 1 panel subjects. To determine the extent of health effects of common co-pollutants that are strongly correlated with PM, we conducted a study of 10 healthy adults over the age of 65 years. We intended to recruit all the subjects from former panel subjects who participated in the Exposure Assessment/Health Study in Year 1. Seven of these subjects were recruited along with three additional subjects who meet the same inclusionary criteria. Subjects were exposed to air or 300 ppb NO2 for 30 minutes at rest. The health measurements were copied from the panel studies: lung function, HRV, arterial oxygen saturation, BP, and symptoms. We added a measurement of exhaled breath from which we measured both exhaled NO and carbon monoxide. Both diastolic and systolic BP increased 10 mmHg after exposure to NO2. The increase in diastolic blood pressure was statistically significant compared with air exposure (p = 0.04).

4. Asthma Cohort

Currently, Jonathan Schildcrout, a research assistant in the Department of Biostatistics advised by Dr. Sheppard, is preparing an analysis of symptoms and air pollution relationships in all the CAMP cities with the possible exception of Toronto. We decided to prepare a multi-city analysis of symptoms in the prerandomization data because the geographic variation in air pollutants adds considerable power to the analysis. We expect to have this analysis completed by the end of 2001. We are in the process of writing the CAMP publication committee requesting permission to prepare this manuscript.

Future Activities:

In Year 3, plans for Project 2a include the following:

1. Analyze the 2-year panel data set for associations between various health endpoint and various air pollutant concentrations. It is estimated that these health endpoint analyses will continue through the end of Year 3.

Health Endpoints:
Blood Pressure?We have started to evaluate possible changes in BP and PM. Blood pressure in these subjects is of special interest at this point since a graduate student saw a small increase in BP in eight of the healthy panel subjects when they were exposed to NO2 in our laboratory. An abstract for the 2002 American Thoracic Society is being considered.

Lung Function?Carol Trenga and Jane Koenig plan to use the good quality spirometric data collected from the children with asthma who participated in the panel study. We purchased six MicroDirect spirometers specifically for use with the children. We have submitted an abstract for presentation at the Society of Risk Assessment meeting in Seattle in December, 2001.

Exhaled NO?Exhaled NO measurements were made in the children with asthma. Karen Jansen is working on the analysis of these data.

2. Conduct various analyses of associations between air pollution and health endpoints in existing data sets:

  • Stagnation index and mortality over a 30-year period in Seattle. The objective is to evaluate whether this model can detect changes in mortality due to substantial changes in air pollution sources from events such as introduction of the catalytic converter and burn bans.

  • Another analysis is an evaluation of PM concentrations and emergency department visits for asthma in Tacoma. This study is in collaboration with Janet Primomo, an Associate Professor in Nursing at the University of Washington in Tacoma. We are concerned about the emergency use of diesel generators approved for Tacoma in the winter of 2000-2001.

  • Extend controlled exposures to gaseous pollutants to our panel subjects with chronic lung disease.

  • Assist with the Firesmoke/Health Study coordinated by Project 2b.

  • Use diet data collected from the panel subjects to estimate fruit and vegetable intake and determine whether that intake is associated with either baseline lung function or sensitivity to PM exposures.

Journal Articles:

No journal articles submitted with this report: View all 27 publications for this subproject

Supplemental Keywords:

ambient particles, fine particles, combustion, health, exposure, biostatistics, susceptibility., RFA, Health, Scientific Discipline, Air, Geographic Area, Waste, particulate matter, Toxicology, air toxics, Environmental Chemistry, Health Risk Assessment, Epidemiology, State, Northwest, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Biochemistry, genetic susceptability, indoor air, Incineration/Combustion, ambient aerosol, ambient air quality, asthma, biostatistics, health effects, particulates, risk assessment, sensitive populations, air pollutants, cardiopulmonary responses, health risks, human health effects, morbidity, exposure and effects, airway disease, ambient air, exposure, animal model, combustion emissions, air pollution, children, Human Health Risk Assessment, particle exposure, cardiopulmonary response, human exposure, inhalation, atmospheric aerosols, ambient particle health effects, combustion, elderly, human susceptibility, incineration, indoor air quality, mortality, California (CA), allergens, age dependent response, aerosols, air quality, atmospheric chemistry, cardiovascular disease, combustion contaminants, exposure assessment, human health risk, particle transport, toxics

Relevant Websites:

http://depts.washington.edu/pmcenter/ Exit EPA icon

Progress and Final Reports:

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

  • Main Center Abstract and Reports:

    R827355    Airborne PM - Northwest Research Center for Particulate Air Pollution and Health

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R827355C001 Epidemiologic Study of Particulate Matter and Cardiopulmonary Mortality
    R827355C002 Health Effects
    R827355C003 Personal PM Exposure Assessment
    R827355C004 Characterization of Fine Particulate Matter
    R827355C005 Mechanisms of Toxicity of Particulate Matter Using Transgenic Mouse Strains
    R827355C006 Toxicology Project -- Controlled Exposure Facility
    R827355C007 Health Effects Research Core
    R827355C008 Exposure Core
    R827355C009 Statistics and Data Core
    R827355C010 Biomarker Core
    R827355C011 Oxidation Stress Makers