Final Report: Identifying Subgroups of the General Population That May Be Susceptible to Short-Term Increases in Particulate Air PollutionEPA Grant Number: R828112C097
Subproject: this is subproject number 097 , established and managed by the Center Director under grant R828112
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
Center: Health Effects Institute (2000 — 2005)
Center Director: Greenbaum, Daniel S.
Title: Identifying Subgroups of the General Population That May Be Susceptible to Short-Term Increases in Particulate Air Pollution
Investigators: Goldberg, Mark S.
Institution: McGill University
EPA Project Officer: Chung, Serena
Project Period: April 1, 2000 through March 31, 2005
RFA: Health Effects Institute (1996) RFA Text | Recipients Lists
Research Category: Health Effects , Air
Objective:Epidemiologic analyses of mid-20th-century air pollution episodes such as the 1952 London Fog indicated that excess mortality was associated with elevated air pollution, and the excess mortality was concentrated among people with preexisting cardiovascular, and especially respiratory, diseases. More recently, smaller associations with mortality have been consistently reported at much lower air pollution levels. However, because these studies used routinely collected mortality data obtained from death certificates, few of the studies could describe in detail the clinical conditions of the decedents preceding their deaths. Therefore, studies that could address this issue were needed.
Summary/Accomplishments (Outputs/Outcomes):In 1994, HEI requested applications for studies that would provide more information on the conditions of individuals before death, to further understanding of the mortality?particulate matter association. Dr Mark Goldberg and his colleagues at McGill University in Montreal, Quebec, received funds to conduct a time-series study in Montreal, where data from the Quebec Health Insurance Plan were available, as well as mortality and air pollution data. Because of the comprehensive nature of this health insurance database, the investigators were able to link individual deaths in Montreal to medical information up to 5 years before death. These data were then used in conjunction with clinical expertise to define susceptible groups and to assess risk of death in those groups for three different indices of particulate matter. The investigators had two major objectives: (1) to determine whether concentrations of particles in the ambient air of Montreal were associated with daily all-cause and cause-specific mortality and (2) to determine whether groups of the population had higher than average risks of death from exposure to particles.
The investigators report total and specific causes of death associated with the average level of air pollution measured the same day and 2 days prior to death (a 3-day mean lag). Three measures of particulate matter were used: coefficient of haze (COH), total sulfate measured at the monitoring station in Sutton, Quebec (150 km south-east of Montreal), and a predicted estimate of particulate matter 2.5 mm or smaller in aerodynamic diameter (PM2.5) that was calculated from daily COH, sulfate, and airport visibility data. Other particulate matter measures were analyzed and are in appendices available on request from the Health Effects Institute and from the HEI web site. For each of the three particle measures, the investigators reported an association with mortality from respiratory diseases and other nonaccidental deaths, including diabetes. Additionally, COH was associated with increases in cancer deaths in general and the subset of lung cancer deaths; sulfate measured at the Sutton site was associated with mortality from coronary artery disease and cardiovascular diseases. Positive associations for other underlying causes of death were not found. All associations were generally stronger among those 65 years of age and older.
Analyses were also conducted for three groups of health conditions present before death (cancer, cardiovascular diseases, and respiratory diseases). The effects of the three particle measures varied somewhat by subset of disease. Subjects with acute lower respiratory disease, congestive heart failure, and a combined group of any cardiovascular diseases died at higher rates for increases in each of the three particulate matter measures. Associations with COH and predicted PM2.5 were reported for subjects with cancer, chronic coronary artery disease, and any coronary artery disease, and effects of sulfate were shown for those with acute and chronic upper respiratory disease. No associations with the three measures of particulate matter were observed for those with airways disease, acute coronary artery disease, or hypertension.
Dr Goldberg and colleagues have made a unique effort to address some of the limitations of mortality outcomes data hat have been used in most earlier studies of air pollution and daily mortality. Their study has advanced current methods and scientific understanding in several ways through the linkage of a provincial insurance database with mortality and air pollution databases. The results suggest that persons with certain preexisting cardiac or respiratory conditions are at short-term increased risk of mortality due to ambient particulate matter. Observed apparent discrepancies between results using case definitions based on the Quebec Health Insurance Plan data and those using the more conventional death certificate information should be more thoroughly explored. Also, some other clinical conditions were identified for a possible association with increased risk of mortality. In particular, the investigators identified persons with cancer or diabetes, as well as those who had not received medical services in the year before death, as being at an increased risk of death. These results merit additional investigation.
Further analyses with this data set could advance understanding of who might be at greatest risk of mortality at levels of air pollution currently observed in the cities with relatively low air pollution levels.
Supplemental Keywords:Air, ambient air quality, air toxics, epidemiology, health effects, particulate matter, biochemistry, motor vehicle emissions, diesel exhaust, human health risk assessment, susceptibility, human exposure, mobile sources., RFA, Health, Scientific Discipline, Air, particulate matter, air toxics, Environmental Chemistry, Health Risk Assessment, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, mobile sources, Biochemistry, Atmospheric Sciences, genetic susceptability, particulates, ambient air quality, risk assessment, sensitive populations, exposure and effects, morbidity, cardiopulmonary responses, human health effects, air pollutants, cardiovascular vulnerability, exposure, environmental risks, pulmonary disease, airway disease, diesel exhaust, air pollution, automotive exhaust, human exposure, cardiopulmonary mechanisms, ambient particle health effects, chronic health effects, lung inflammation, diesel exhaust particles, Acute health effects, environmentally caused disease, human susceptibility, mortality, indoor air quality, human health, exposure assessment, air quality, respiratory, human health risk
Progress and Final Reports:Original Abstract
Main Center Abstract and Reports:R828112 Health Effects Institute (2000 — 2005)
Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R828112C042 Does Inhalation of Methanol Vapor Affect Human Neurobehavior?
R828112C043 Human Responses to Nitrogen Dioxide
R828112C044 The Role of Inflammation in Ozone-Induced Lung Injury
R828112C045 How Does Exercise Affect the Dose of Inhaled Air Pollutants?
R828112C046 How Do Chemicals in Diesel Engine Exhaust Damage DNA?
R828112C047 Effect of Nitrogen Dioxide on Bacterial Respiratory infection in Mice
R828112C048 Effects of Ozone Exposure on Airway Epithelium
R828112C049 Inhalation of Aldehydes and Effects on Breathing
R828112C050 Does Ozone Cause Precancerous Changes in Cells?
R828112C051 Effects of Formaldehyde on Human Airway Epithelial Cells Exposed in a Novel Culture System
R828112C052 Carbon Monoxide and Cardiac Arrhythmias
R828112C053 Effects of Formaldehyde and Particle-Bound Formaldehyde on Lung Macrophage Functions
R828112C054 Mechanisms for Protecting Lung Epithelial Cells Against Oxidant Injury
R828112C055 Relationship of Nitropyrene-Derived DNA Adducts to Carcinogenesis
R828112C056 Particle Trap Effects on Heavy-Duty Diesel Engine Emissions
R828112C057 Carbon Monoxide and Atherosclerosis
R828112C058 Nitrogen Dioxide and Respiratory Illness in Children
R828112C059 Noninvasive Methods for Measuring Ventilation in Mobile Subjects
R828112C060 Oxidant Air Pollutants and Lung Cancer: An Animal Model
R828112C061 Detection of Carcinogen-DNA Adducts: Development of New Methods
R828112C062 Effects of Carbon Monoxide on Heart Muscle Cells
R828112C063 Development of Personal Ozone Samplers: Three Approaches
R828112C064 Development of Biomarkers to Monitor Carcinogen Exposure
R828112C065 Effects of Prolonged Ozone Inhalation on Collagen Structure and Content in Rat Lungs
R828112C065II Prolonged Ozone Exposure and the Contractile Properties of Isolated Rat Airways
R828112C065III Changes in Complex Carbohydrate Content and Structure in Rat Lungs Caused by Prolonged Ozone Inhalation
R828112C065IV Genetic Control of Connective Tissue Protein Synthesis After Prolonged Ozone Inhalation
R828112C065V Pulmonary Function Alterations in Rats After Chronic Ozone Inhalation
R828112C065VII Prolonged Ozone Exposure Leads to Functional and Structural Changes in the Rat Nose
R828112C065VIII - IX Studies of Changes in Lung Structure and Enzyme Activitiesin Rats After Prolonged Exposure to Ozone
R828112C065X An Innovative Approach to Analyzing Multiple Experimental Outcomes: A Case Study of Rats Exposed to Ozone
R828112C065XI The Consequences of Prolonged Inhalation of Ozone on Rats: An Integrative Summary of the Results of Eight Collaborative Studies
R828112C066 Interactive Effects of Nitropyrenes in Diesel Exhaust
R828112C067 Detection of FormaldehydeDNA Adducts: Development of New Methods
R828112C068I Comparison of the Carcinogenicity of Diesel Exhaust and Carbon Black in Rat Lungs
R828112C068II An Investigation of DNA Damage in the Lungs of Rats Exposed to Diesel Exhaust
R828112C068III No Evidence For Genetic Mutations Found In Lung Tumors From Rats Exposed To Diesel Exhaust or Carbon Black
R828112C069 Noninvasive Determination of Respiratory Ozone Absorption: The Bolus-Response Method
R828112C070 The Effects of Inhaled Oxidants and Acid Aerosols on Pulmonary Function
R828112C071 Biochemical Consequences of Ozone Reacting with Membrane Fatty Acids
R828112C072 DNA Mutations in Rats Treated with a Carcinogen Present in Diesel Exhaust
R828112C073 Developmental Neurotoxicity of Inhaled Methanol in Rats
R828112C074 Methanol Distribution in Non Pregnant and Pregnant Rodents
R828112C075 Is Increased Mortality Associated with Ozone Exposure in Mexico City?
R828112C076 Effects of Fuel Modification and Emission Control Devices on Heavy-Duty Diesel Engine Emissions
R828112C077 Metabolic Studies in Monkeys Exposed to Methanol Vapors
R828112C078 Effects of Ozone on Pulmonary Function and Airway Inflammation in Normal and Potentially Sensitive Human Subjects
R828112C079 Improvement of a Respiratory Ozone Analyzer
R828112C080 Mechanism of Oxidative Stress from Low Levels of Carbon Monoxide
R828112C081 Long-Term Exposure to Ozone: Development of Methods to Estimate Past Exposures and Health Outcomes
R828112C082 Effects of Ambient Ozone on Healthy, Wheezy, and Asthmatic Children
R828112C083 Daily Changes in Oxygen Saturation and Pulse Rate Associated with Particulate Air Pollution and Barometric Pressure
R828112C084 Evaluation of The Potential Health Effects of the Atmospheric Reaction Products of Polycyclic Aromatic Hydrocarbons
R828112C085 Mechanisms of Response to Ozone Exposure: The Role of Mast Cells in Mice
R828112C086 Statistical Methods for Epidemiologic Studies of the Health Effects of Air Pollution
R828112C087 Development of New Methods to Measure Benzene Biomarkers
R828112C088 Alveolar Changes in Rat Lungs After Long-Term Exposure to Nitric Oxide
R828112C089 Effects of Prenatal Exposure to Inhaled Methanol on Nonhuman Primates and Their Infant Offspring
R828112C090 A Pilot Study of Potential Biomarkers of Ozone Exposure
R828112C091 Effects of Concentrated Ambient Particles on the Cardiac and Pulmonary Systems of Dogs
R828112C092 Cancer, Mutations, and Adducts in Rats and Mice Exposed to Butadiene and Its Metabolites
R828112C093 Effects of Concentrated Ambient Particles in Rats and Hamsters: An Exploratory Study
R828112C094I The National Morbidity, Mortality, and Air Pollution Study: Methods and Methodologic Issues
R828112C094II The National Morbidity, Mortality, and Air Pollution Study: Morbidity and Mortality from Air Pollution in the United States
R828112C095 Association of Particulate Matter Components with Daily Mortality and Morbidity in Urban Populations
R828112C096 Acute Pulmonary Effects of Ultrafine Particles in Rats and Mice
R828112C097 Identifying Subgroups of the General Population That May Be Susceptible to Short-Term Increases in Particulate Air Pollution
R828112C098 Daily Mortality and Fine and Ultrafine Particles in Erfurt, Germany
R828112C099 A Case-Crossover Analysis of Fine Particulate Matter Air Pollution and Out-of-Hospital Sudden Cardiac Arrest
R828112C100 Effects of Mexico City Air on Rat Nose
R828112C101 Penetration of Lung Lining and Clearance of Particles Containing Benzo[a]pyrene
R828112C102 Metabolism of Ether Oxygenates Added to Gasoline
R828112C103 Characterization and Mechanisms of Chromosomal Alterations Induced by Benzene in Mice and Humans
R828112C104 Acute Cardiovascular Effects in Rats from Exposure to Urban Ambient Particles
R828112C105 Genetic Differences in Induction of Acute Lung Injury and Inflammation in Mice
R828112C106 Effects on Mice of Exposure to Ozone and Ambient Particle Pollution
R828112C107 Emissions from Diesel and Gasoline Engines Measured in Highway Tunnels
R828112C108 Case-Cohort Study of Styrene Exposure and Ischemic Heart Disease Investigators
R828112C110 Effects of Metals Bound to Particulate Matter on Human Lung Epithelial Cells
R828112C111 Effect of Concentrated Ambient Particulate Matter on Blood Coagulation Parameters in Rats
R828112C112 Health Effects of Acute Exposure to Air Pollution
R828112C113 Benzene Metabolism in Rodents at Doses Relevant to Human Exposure from Urban Air
R828112C114 A Personal Particle Speciation Sampler
R828112C115 Validation and Evaluation of Biomarkers in Workers Exposed to Benzene in China
R828112C116 Biomarkers in Czech Workers Exposed to 1,3-Butadiene: A Transitional Epidemiologic Study
R828112C117 Peroxides and Macrophages in the Toxicity of Fine Particulate Matter in Rats
R828112C118 Controlled Exposures of Healthy and Asthmatic Volunteers to Concentrated Ambient Particles in Metropolitan Los Angeles
R828112C119 Manganese Toxicokinetics at the Blood-Brain Barrier
R828112C120 Effects of Exposure to Concentrated Ambient Particles from Detroit Air on Healthy Rats and Rats with Features of Asthma or Mild Bronchitis
R828112C121 Field Evaluation of Nanofilm Detectors for Measuring Acidic Particles in Indoor and Outdoor Air
R828112C123 Time-Series Analysis of Air Pollution and Mortality: A Statistical Review
R828112C126 Effects of Exposure to Ultrafine Carbon Particles in Healthy Subjects and Subjects with Asthma
R828112C128 Neurogenic Responses of Rat Lung to Diesel Exhaust
R828112C130-I Relationships of Indoor, Outdoor, and Personal Air (RIOPA). Part I. Collection Methods and Descriptive Analyses
R828112C132 An Updated Study of Mortality Among North American Synthetic Rubber Industry Workers