2000 Progress Report: Epidemiologic Study of Particulate Matter and Cardiopulmonary Mortality

EPA Grant Number: R827355C001
Subproject: this is subproject number 001 , 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: Epidemiologic Study of Particulate Matter and Cardiopulmonary Mortality
Investigators: Kaufman, Joel D. , Checkoway, Harvey , Koenig, Jane Q. , Sheppard, Lianne (Elizabeth) A. , Siscovick, David
Current Investigators: Kaufman, Joel D. , Ishikawa, Naomi , Karr, Catharine J. , Miller, Kristine , Schreuder, Astrid , Shepherd, Kristine , Sheppard, Lianne (Elizabeth) A. , Siscovick, David , Sullivan, Jeff
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 project consists of two study designs addressing associations between ambient PM exposure and cardiorespiratory disease risks. The first design is a "case-crossover" study of roughly 1,100 out-of-hospital sudden cardiac arrest (SCA) cases in Seattle. This design compares PM levels in the days immediately preceding SCA events with levels at previous reference time points. The second study, starting in the fall of 2001, will examine the chronic effects of exposure to ambient particulate matter in a multicity cohort being observed for the occurrence of cardiovascular disease.

Progress Summary:

The second year of the project has been focused on completing the case-crossover analysis of sudden cardiac arrest in King County. Although our initial study of primary cardiac arrest using this methodology (Levy, 2001a; Levy, 2001b) involved 362 cases without any preexisting illness, this analysis uses a different and more heterogeneous sample of 1,206 out-of-hospital cardiac arrest cases in the Seattle region. More than one-half of these cases had preexisting cardiovascular disease.

Jeffrey Sullivan, M.D., M.H.S., Senior Fellow, has taken a major role in conducting the analysis for this project. The tables that follow demonstrate the characteristics of the cases and the exposure information being used. The past year has involved preparation and cleaning of the case and exposure databases, and the case-crossover analysis is now ongoing. We anticipate completion of data analysis by early summer 2001. This likely will include incorporation of models with lags of 1- and 4-hours as recently reported by Peters and colleagues (Peters, 2001).

Table 1. 1,206 cases of SCA in King County and South Snohomish County 1985-95

Variable Frequency (percent)
Age (median) 67.4
Female gender 347/1206 (28.8%)
Race (non-white) 117/1206 (9.7%)
Smoking (ever) 721/1151 (62.6%)






Complete data not available on all characteristics of all cases.


Table 2. Clinical characteristics of 1,206 cases of sudden cardiac death

Variable Frequency (percent)
Heart disease 660

Congestive Heart Failure (CHF) (within 1 year of CHF severity


Class I


Class II


Class III




Valvular Disease


Prior Myocardial Infarction


Angina (within 1 year of sudden death)







164(afib) 47(flutter)

Ventricular Tachycardia History



Prior Stroke 113
Hypercholesterolemia 53
Diabetes 235

Type I


Type II

Chronic Obstructive Pulmonary Disease 232 (117 with PFTs)
Asthma 110
Healthy ?

Table 3. Occurrence of cases by year

Year Frequency Percent Cumulative
1985 139 11.53 11.53
1986 141 11.69 23.22
1987 110 9.12 32.34
1988 115 9.54 41.87
1989 111 9.20 51.08
1990 121 10.03 61.11
1991 128 10.61 71.72
1992 95 7.88 79.60
1993 144 11.94 91.54
1994 102 8.46 100.00
Total 1,206 100.00  

Table 4. Descriptive statistics for pollutants (nephelometer, PM10, SO2, CO, temperature)

Variable Units N Min 10% 25% 50% 75% 90% Max Mean
Neph 10km-1 bsp 5254 .05 .2257 .3127 .4790 .8497 1.5000 5.99 .7108
PM10 µg/m3 1776 7.38 13.78 17.97 24.83 35.13 45.60 89.83 28.05
SO2 ppm 5069 .00 .002500 .004872 .007609 .01042 .01364 .03 .00797
CO ppm 5300 .52 1.0208 1.2983 1.7083 2.2771 3.0083 7.56 1.9024
Temp F 5041 15.00 40.00 45.00 52.00 60.00 66.00 79.00 52.510

Future Activities:

Beginning in fall 2001, we will launch a new epidemiologic study of a multi-city cohort being observed for the occurrence of cardiovascular disease in a large number of cities with available PM monitoring data. We anticipate being able to study the effect of chronic exposure to ambient PM on incidence of cardiovascular disease in this cohort using a proportional hazards model approach.

Journal Articles on this Report : 3 Displayed | Download in RIS Format

Other subproject views: All 21 publications 14 publications in selected types All 14 journal articles
Other center views: All 209 publications 113 publications in selected types All 109 journal articles
Type Citation Sub Project Document Sources
Journal Article Levy D, Sheppard L, Checkoway H, Kaufman J, Lumley T, Koenig J, Siscovick D. A case-crossover analysis of particulate matter air pollution and out-of-hospital primary cardiac arrest. Epidemiology 2001;12(2):193-199. R827355 (2004)
R827355 (Final)
R827355C001 (2000)
R827355C001 (2001)
  • Abstract from PubMed
  • Full-text: LWW-Full Text HTML
  • Abstract: LWW-Abstract
  • Other: LWW-Full Text PDF
  • Journal Article Levy D, Lumley T, Sheppard L, Kaufman J, Checkoway H. Referent selection in case-crossover analyses of acute health effects of air pollution. Epidemiology 2001;12(2):186-192. R827355 (2004)
    R827355 (Final)
    R827355C001 (2000)
    R827355C001 (2001)
    R825173 (1999)
    R825173 (2000)
  • Abstract from PubMed
  • Full-text: Epidemiology-Full Text HTML
  • Abstract: Epidemiology-Abstract
  • Other: Epidemiology-Full Text PDF
  • Journal Article Lumley T, Sheppard L. Assessing seasonal confounding and model selection bias in air pollution epidemiology using positive and negative control analyses. Environmetrics 2000;11(6):705-717. R827355 (2001)
    R827355 (Final)
    R827355C001 (2000)
    R827355C001 (2001)
    R827355C009 (Final)
    R825173 (1999)
  • Abstract: Wiley-Abstract
  • Other: University of Washington-Prepublication paper
  • Supplemental Keywords:

    ambient particles, fine particles, combustion, health, exposure, biostatistics, susceptibility., RFA, Health, Scientific Discipline, PHYSICAL ASPECTS, Air, Geographic Area, particulate matter, Toxicology, air toxics, Environmental Chemistry, Health Risk Assessment, Epidemiology, State, Northwest, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Allergens/Asthma, Biochemistry, Physical Processes, Children's Health, genetic susceptability, indoor air, Atmospheric Sciences, 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, acute cardiovascular effects, airway disease, ambient air, exposure, hazardous air pollutants, animal model, epidemelogy, combustion emissions, biological response, air pollution, children, Human Health Risk Assessment, airway inflammation, particle exposure, airborne pollutants, cardiopulmonary response, human exposure, inhalation, PAHs, atmospheric aerosols, children's vulnerablity, assessment of exposure, ambient particle health effects, mortality studies, combustion, harmful environmental agents, hydrocarbons, epidemeology, human susceptibility, biological markers, incineration, indoor air quality, mortality, California (CA), allergens, aerosols, air quality, allergen, atmospheric chemistry, cardiovascular disease, combustion contaminants, exposure assessment, human health risk, indoor environment, 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
  • 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