Chronic Exposure to Particulate Matter and Cardiopulmonary DiseaseEPA Grant Number: R830545
Title: Chronic Exposure to Particulate Matter and Cardiopulmonary Disease
Investigators: Laden, Francine , Camargo, Carlos , Schwartz, Joel , Speizer, Frank E. , Suh, Helen H.
Current Investigators: Laden, Francine , Camargo, Carlos , Puett, Robin C. , Schwartz, Joel , Speizer, Frank E. , Suh, Helen H. , Yanosky, Jeff D.
Institution: Brigham and Women's Hospital, Inc.
EPA Project Officer: Chung, Serena
Project Period: January 20, 2003 through January 19, 2006 (Extended to January 19, 2008)
Project Amount: $933,602
RFA: Epidemiologic Research on Health Effects of Long-Term Exposure to Ambient Particulate Matter and Other Air Pollutants (2002) RFA Text | Recipients Lists
Research Category: Air Quality and Air Toxics , Health Effects , Particulate Matter , Air
The objective of this study is to evaluate the association of long term exposure to air pollution with incident coronary and respiratory disease and with total mortality. The study population will be the Nurses' Health Study (NHS), an ongoing prospective cohort study of 121,700 women residing throughout the U.S. We hypothesize that the incidence of these diseases and total mortality are positively associated with air pollution and that exposure to air pollution exacerbates existing disease. We also hypothesize that the association with coronary heart disease will be greater among diabetics than nondiabetics and that consumption of antioxidants will modify the association.
The basic approach is threefold: (1) to use existing data sources to create a model for exposure to air pollution throughout the U.S.; (2) to link the yearly average exposure to the residential addresses of the study participants; and (3) to evaluate the relative risk of the outcomes in the high compared with the low exposure areas. We will model long-term exposure to air pollution for the years 1986 through 2000 using data from the EPA's Aerometric Information Retrieval System (AIRS), the National Emissions Trends database, National Oceanic and Atmospheric Association, and commercially available traffic count data. Existing ambient monitoring data from specific sites will be used to supplement this information. Residential addresses are updated every two years and will be mapped using geographic information system (GIS) software and linked to the exposure model. Incident cases of cardiovascular disease and of chronic obstructive pulmonary disease, asthma, and lung cancer, diagnosed during the study period, are identified routinely on the NHS biennial self-administered questionnaire. Cases are confirmed by supplemental questionnaire and review of medical records. Mortality is reported by next-of-kin and also obtained by regular searches of the National Death Index. We will estimate the relative risks of these outcomes associated with air pollution using the proportional hazards model, including adjustment for smoking, and other confounders. We will also assess interactions with comorbid diabetes and consumption of antioxidants.
Although there is a substantial body of literature demonstrating the adverse health effects associated with air pollution, to date there have only been two large cohort studies of mortality. This proposed study will not only evaluate mortality but it will be the first study to prospectively evaluate cause-specific incident disease on a nationwide basis. Further, it will provide information on the extent of life shortening associated with the exposure by measuring survival and severity of disease after the first event.