2011 Progress Report: Prospective Study of Atherosclerosis, Clinical Cardiovascular Disease, and Long-Term Exposure to Ambient Particulate Matter and Other Air Pollutants in a Multi-Ethnic Cohort (MESA Air)

EPA Grant Number: R831697
Title: Prospective Study of Atherosclerosis, Clinical Cardiovascular Disease, and Long-Term Exposure to Ambient Particulate Matter and Other Air Pollutants in a Multi-Ethnic Cohort (MESA Air)
Investigators: Kaufman, Joel D. , Adar, Sara D. , Astor, Brad , Avol, Edward L. , Barr, R. Graham , Budoff, Matthew , Burke, Gregory L. , Daviglus, Martha , Detrano, Robert , Diez Roux, Ana V. , Folsom, Aaron , Gross, Myron , Jacobs, David , Kinney, Patrick L. , Kronmal, Richard , Larson, Timothy V. , Liu, Kiang J. , Liu, Sally , Lumley, Thomas , Navas-Acien, Ana , Nyerges, Timothy , OLeary, Daniel , Saad, Mohammed , Sampson, Paul , Seixas, Noah , Shea, Steven , Sheppard, Lianne (Elizabeth) A. , Siscovick, David , Stein, James , Wang, Yinhai , Watson, Karol
Current Investigators: Kaufman, Joel D. , Adar, Sara D. , Barr, R. Graham , Budoff, Matthew , Burke, Gregory L. , Daviglus, Martha , Diez Roux, Ana V. , Goldstein, James , Jacobs, David , Kronmal, Richard , Larson, Timothy V. , Liu, Kiang J. , Navas-Acien, Ana , Sampson, Paul , Sheppard, Lianne (Elizabeth) A. , Siscovick, David , Szpiro, Adam , Watson, Karol
Institution: University of Washington , Columbia University in the City of New York , Northwestern University , The Johns Hopkins University , Tufts University , University of California - Los Angeles , University of Michigan , University of Minnesota , University of Southern California , University of Vermont , University of Wisconsin Madison , Wake Forest University
Current Institution: University of Washington , Columbia University in the City of New York , Northwestern University , Tellus Institute , The Johns Hopkins University , University of California - Los Angeles , University of Michigan , University of Minnesota
EPA Project Officer: Ilacqua, Vito
Project Period: August 1, 2004 through July 31, 2014
Project Period Covered by this Report: August 1, 2010 through July 31,2011
Project Amount: $32,999,090
RFA: Epidemiologic Research on Health Effects of Long-Term Exposure to Ambient Particulate Matter and Other Air Pollutants (2003) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Health Effects , Particulate Matter , Air

Objective:

The goal of the Multi-Ethnic Study of Atherosclerosis and Air Pollution Study (MESA Air) is to prospectively examine the relation between an individual level assessment of long-term ambient air pollution exposure (including PM2.5 and gaseous co-pollutants) and the progression of subclinical cardiovascular disease in a multi-city, multi-ethnic cohort. MESA Air also will prospectively examine the relation between an individual level assessment of long-term ambient air pollution exposures and the incidence of cardiovascular disease, including myocardial infarction and cardiovascular death.

Progress Summary:

Progress Summary:
During the seventh year of MESA Air, the research team has:
  • Developed likelihood-based exposure models for NOX and NO2 concentrations across the MESA Air study regions, and produced ambient exposure predictions for each MESA Air participant at 2-week resolution from 1999-2009.
  • Refined the pragmatic spatio-temporal approach to modeling ambient PM2.5 concentrations across the MESA Air study regions, expanding the time coverage to 1999-2009 and including additional geographic variables.
  • Developed a comprehensive exposure database including geographic variables, exposure model predictions, AQS and MESA Air monitoring data, participant residential locations to ensure accurate and reproducible production of datasets for exposure and health models.
  • Developed city- and season-specific infiltration models for PM2.5 into participants’ residences, employing information from each participants’ MESA Air Questionnaire and more than 800 paired indoor/outdoor sulfur tracer measurements collected at MESA Air participants’ homes.
  • Collaborated with MESA investigators to support Exam 5 clinic visits for 4,325 MESA Air participants, and collected MESA Air Questionnaire data, including information relevant to pollutant infiltration, from 95% of these participants.
  • Acquired 3,041 carotid ultrasounds and 2,769 CT scans, representing 84% and 77%, respectively, of the ultimate goals.
  • Published analyses of the impact of air pollution exposure on cardiac electrical activity, gene-environment interactions and left ventricular mass, arterial stiffness, and heart rate variability.
 
1. Work status and progress
Three major efforts occupied the majority of MESA Air Project Year 7, which spanned August 1, 2010 through July 31, 2011. MESA Exam 5 was under way throughout this year, and MESA Air was significantly involved in the planning, organization and operation of this exam, particularly with respect to acquisition of CT scans and ultrasounds, as well as with the planning of the clinic exams for those participants specifically recruited for MESA Air in Coastal LA, Riverside County, CA, and Rockland, NY. In addition, the statistical and biostatical research team at the University of Washington was heavily involved in progressing the exposure modeling efforts, including developing a likelihood-based exposure model for NOx and NO2, and completing pragmatic modeling efforts for PM2.5. Finally, the epidemiological and biostatistical research team made significant progress in planning the ultimate MESA Air health analyses, and in conducting interim analyses. All three of these efforts are described below in more detail.
 
Clinic Exam 5
MESA Exam 5 (the MESA Air follow-up examination) began in April 2010, and components of this exam are scheduled to continue through January 2012. This is an extension from the original plan, where the exam was to conclude in October 2011, and is intended to improve retention. Table 1, below, shows the progress to date of MESA Exam 5, highlighting those clinic components sponsored by MESA Air.
 
 
 
Table 1. Number of MESA Air participants selected for and completing MESA. Air components of MESA Exam 5. Areas in italics represent communities in which MESA Air recruited de novo participants specifically to increase heterogeneity in air pollution exposure.
 
 
As shown above, 95% of the MESA Air participants returning for an Exam 5 clinic visit have completed the MESA Air Questionnaire. The project goal for high tech tests is to complete a total of 3600 cardiac CTs and carotid ultrasounds at Exam 5 for the primary subclinical progression analyses. To date, 3041 ultrasounds (84% of goal) and 2769 CT scans (77% of goal) have been acquired.
 
Exposure Modeling
Exposure modeling efforts for ambient air pollution encompass three primary pollutant types:  modeling of PM2.5 concentrations; modeling of the oxides of nitrogen (NO2/NOx); and modeling of light-absorbing carbon, as an additional indicator for traffic-related exposures. During Year 7, MESA Air refined the interim estimates for ambient PM2.5 concentrations described in the last annual report, and published this methodology, which uses a hierarchical, pragmatic spatio-temporal approach to exploit both regulatory and MESA Air monitoring data (published in Atmospheric Environment by Sampson, et al., 2011). Progress also has been made in developing a final set of likelihood-based estimates, which will be produced during Year 8. During Year 7, MESA Air also completed a likelihood-based exposure model for ambient NOx and NO2 concentrations, and those predictions have been produced and are being used in health analyses including studies of left ventricular mass, brachial artery outcomes and intima-media thickness. Likelihood-based modeling of light-absorbing carbon also is well under way, and ambient exposure predictions of LAC are expected in Year 8.
 
In addition to the ambient modeling described above, there also has been significant progress over the past year on modeling of PM2.5 infiltration efficiency into participants’ residences. Utilizing the home characteristics collected from all participants as part of the MESA Air Questionnaire and measurements of sulfur concentrations on Teflon filters inside and outside of participants’ homes (as a tracer for fine particles), we have developed city- and season-specific infiltration models that can be applied at the individual-level for all participants.
 
Health effects
Significant progress has been made over the past year on health modeling, including planning and preparation for the final analysis as well as publication of interim analyses. We have developed an alternate scoring system for coronary artery calcium, one of the studies’ primary outcome measures, which will allow us to understand CAC as a continuous variable, utilizing more of the information available from a cardiac CT scan than is presently employed in the Agatston score. A manuscript describing this work has been submitted (Liang, et al., submitted). We also have been working to develop our statistical analysis plans for our primary analyses of atherosclerosis progression; these analyses cannot be conducted until Exam 5 is complete.
 

2. Results to date
While it is still too early to report on associations between our air pollution exposure estimates and the primary measures of subclinical progression (for which we are dependent on the conclusion of MESA Exam 5) or clinical events, we can provide several important sets of results to date, both in terms of exposure estimation and in terms of health outcomes. With regards to exposure estimation, we have successfully developed estimates of PM2.5 concentrations at participant residences across the MESA Air cities in 2-week intervals from 1999-2009. This approach (or “pragmatic” approach, which precedes the likelihood-based approach now under development) has been published (Sampson, et al., 2011) and is being used in a variety of initial health analyses, both at the University of Washington and at collaborating universities. We also have developed likelihood-based NOx and NO2 estimates for all of the MESA regions for 2-week intervals from 1999-2009, and these estimates also are being used in a variety of health analyses at our institution and others. The methods describing these estimates are described in manuscripts that have been published (Mercer, et al., 2011) or that have been submitted for publication (Lindström, et al., submitted). Our exposure modeling results also have included a new understanding of measurement error in air pollution exposure modeling (Szpiro, et al., 2010).
 
Finally with respect to exposure modeling, we have successfully developed models to estimate particulate matter infiltration into the residences of each of the MESA Air study participants, which will allow us to predict not just the ambient PM2.5 concentration outdoors at participants’ homes but also what infiltrates into their homes (Allen, et al., submitted), thus moving us toward an actual prediction of exposure, rather than just concentration.
 
In addition to our exposure modeling progress, we also have made progress with regards to health analyses. We now have a better understanding of the effect of gene-environment interactions and left ventricular mass (Van Hee, et al., 2010), air pollution exposure on cardiac electrical activity (Van Hee, et al., 2011), heart rate variability (Park, et al., 2010) and arterial stiffness (O’Neill, et al., 2011). We also have summarized the more global understanding of the cardiovascular health effects of air pollution that has been gained through all of the work occurring in the MESA cohort (Gill, et al., 2011).

 

Future Activities:

Planned activities for the 2011-2012 reporting period
 
During the next year, we will work with the Field Centers and the Coordinating Center to conclude Exam 5 activities. With the conclusion of Exam 5, we will be able to develop final datasets from the cardiac CT and carotid ultrasound data, which ultimately will be used in the long-term studies of atherosclerosis progression. We will continue to work with MESA to collect data on clinical cardiovascular events, although the ultimate event dataset will be delayed as long as possible to allow accrual of as many events as possible. We also will continue to support the collection of Air Questionnaire data from MESA Air participants as part of the planned MESA follow up phone calls.
 
While all of the air pollution monitoring and the majority of the air pollutant exposure modeling are now complete, there are still two outstanding exposure models:  a likelihood-based PM2.5 model and a likelihood-based LAC model, both of which we anticipate completing during the next project year. As additional data are reported and uploaded by the AQS monitoring system, and as we continue to improve the quality and quantity of variables in our geographic database, we also will continue to update and refine our existing likelihood-based NOx and NO2 models. We now have developed infiltration models to allow predictions of PM2.5 infiltration into participants’ residences; in the next project year, we will develop exposure predictions for each participant that incorporate both the predicted indoor and outdoor concentrations as a time-weighted average based on each participants’ reported patterns of time-location.
 
We will continue to conduct early health analyses, to develop plans for ultimate health modeling strategies, and to emphasize publications. Expected publications in the coming year, which focus on using the long-term exposure modeling results in early health analyses, include an analysis of systemic vascular response (Krishnan, et al.), serum and plasma biomarkers of endothelial activation (Van Hee, et al.), and lung density (Adar, et al.).
 
Lastly, we also will continue to support the efforts of the many MESA Air ancillary studies, including the new EPA-funded University of Washington Center for Clean Air Research, which includes a study of in-vehicle air pollution exposures to MESA Air participants; the MESA Coarse study, looking at the health effects of exposure to PM10-2.5 in MESA Air participants; and the NIEHS-funded DISCOVER center, which includes increasing understanding of gene-environment effects within the MESA Air cohort.


Journal Articles on this Report : 20 Displayed | Download in RIS Format

Other project views: All 253 publications 134 publications in selected types All 133 journal articles
Type Citation Project Document Sources
Journal Article Adar SD, Kaufman JD. Cardiovascular disease and air pollutants: evaluating and improving epidemiological data implicating traffic exposure. Inhalation Toxicology 2007;19(Suppl 1):135-149. R831697 (2008)
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  • Journal Article Adar SD, Klein R, Klein BE, Szpiro AA, Cotch MF, Wong TY, O'Neill MS, Shrager S, Barr RG, Siscovick DS, Daviglus ML, Sampson PD, Kaufman JD. Air pollution and the microvasculature: a cross-sectional assessment of in vivo retinal images in the population-based Multi-Ethnic Study of Atherosclerosis (MESA). PLoS Medicine 2010;7(11):e1000372 (11 pp.). R831697 (2010)
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  • Journal Article Allen RW, Davies H, Cohen MA, Mallach G, Kaufman JD, Adar SD. The spatial relationship between traffic-generated air pollution and noise in 2 US cities. Environmental Research 2009;109(3):334-342. R831697 (2010)
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  • Journal Article Allen RW, Criqui MH, Diez Roux AV, Allison M, Shea S, Detrano R, Sheppard L, Wong ND, Stukovsky KH, Kaufman JD. Fine particulate matter air pollution, proximity to traffic, and aortic atherosclerosis. Epidemiology 2009;20(2):254-264. R831697 (2009)
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  • Journal Article Auchincloss AH, Diez Roux AV, Dvonch JT, Brown PL, Barr RG, Daviglus ML, Goff Jr. DC, Kaufman JD, O'Neill MS. Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-Ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives 2008;116(4):486-491. R831697 (2009)
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  • Journal Article Cohen MA, Adar SD, Allen RW, Avol E, Curl CL, Gould T, Hardie D, Ho A, Kinney P, Larson TV, Sampson P, Sheppard L, Stukovsky KD, Swan SS, Liu L-J, Kaufman JD. Approach to estimating participant pollutant exposures in the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Environmental Science & Technology 2009;43(13):4687-4693. R831697 (2009)
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  • Journal Article Gill EA, Curl CL, Adar SD, Allen RW, Auchincloss AH, O’Neill MS, Park SK, Van Hee VC, Diez Roux AV, Kaufman JD. Air pollution and cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. Progress in Cardiovascular Diseases 2011;53(5):353-360. R831697 (2011)
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  • Journal Article Jensen SS, Larson T, Deepti KC, Kaufman JD. Modeling traffic air pollution in street canyons in New York City for intra-urban exposure assessment in the US Multi-Ethnic Study of atherosclerosis and air pollution. Atmospheric Environment 2009;43(30):4544-4556. R831697 (2009)
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  • Journal Article Kim S-Y, Sheppard L, Kim H. Health effects of long-term air pollution:influence of exposure prediction methods. Epidemiology 2009;20(3):442-450. R831697 (2010)
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  • Journal Article Mercer LD, Szpiro AA, Sheppard L, Lindstrom J, Adar SD, Allen RW, Avol EL, Oron AP, Larson T, Liu L-JS, Kaufman JD. Comparing universal kriging and land-use regression for predicting concentrations of gaseous oxides of nitrogen (NOx) for the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Atmospheric Environment 2011;45(26):4412-4420. R831697 (2011)
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  • Journal Article O'Neill MS, Diez-Roux AV, Auchincloss AH, Shen M, Lima JA, Polak JF, Barr RG, Kaufman J, Jacobs Jr. DR. Long-term exposure to airborne particles and arterial stiffness: the Multi-Ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives 2011;119(6):844-851. R831697 (2011)
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  • Journal Article Park SK, Auchincloss AH, O'Neill MS, Prineas R, Correa JC, Keeler J, Barr RG, Kaufman JD, Diez Roux AV. Particulate air pollution, metabolic syndrome, and heart rate variability: the Multi-Ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives 2010;118(10):1406-1411. R831697 (2010)
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  • Journal Article Poplawski K, Gould T, Setton E, Allen R, Su J, Larson T, Henderson S, Brauer M, Hystad P, Lightowlers C, Keller P, Cohen M, Silva C, Buzzelli M. Intercity transferability of land use regression models for estimating ambient concentrations of nitrogen dioxide. Journal of Exposure Science & Environmental Epidemiology 2009;19(1):107-117. R831697 (2009)
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  • Journal Article Sampson PD, Szpiro AA, Sheppard L, Lindstrom J, Kaufman JD. Pragmatic estimation of a spatio-temporal air quality model with irregular monitoring data. Atmospheric Environment 2011;45(36):6593-6606. R831697 (2011)
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  • Journal Article Su JG, Larson T, Gould T, Cohen M, Buzzelli M. Transboundary air pollution and environmental justice:Vancouver and Seattle compared. GeoJournal 2010;75(6):595-608. R831697 (2010)
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  • Journal Article Szpiro AA, Sampson PD, Sheppard L, Lumley T, Adar SD, Kaufman JD. Predicting intra-urban variation in air pollution concentrations with complex spatio-temporal dependencies. Environmetrics 2010;21(6):606-631. R831697 (2010)
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  • Journal Article Van Hee VC, Adar SD, Szpiro AA, Barr RG, Diez Roux A, Bluemke DA, Sheppard L, Gill EA, Bahrami H, Wassel C, Sale MM, Siscovick DS, Rotter JI, Rich SS, Kaufman JD. Common genetic variation, residential proximity to traffic exposure, and left ventricular mass:the Multi-Ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives 2010;118(7):962-969. R831697 (2010)
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  • Journal Article Van Hee VC, Adar SD, Szpiro AA, Barr RG, Bluemke DA, Diez Roux AV, Gill EA, Sheppard L, Kaufman JD. Exposure to traffic and left ventricular mass and function:the Multi-Ethnic Study of Atherosclerosis. American Journal of Respiratory and Critical Care Medicine 2009;179(9):827-834. R831697 (2009)
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  • Journal Article Van Hee VC, Szpiro AA, Prineas R, Neyer J, Watson K, Siscovick D, Kyun Park S, Kaufman JD. Association of long-term air pollution with ventricular conduction and repolarization abnormalities. Epidemiology 2011;22(6):773-780. R831697 (2011)
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  • Journal Article Wilton D, Szpiro A, Gould T, Larson T. Improving spatial concentration estimates for nitrogen oxides using a hybrid meteorological dispersion/land use regression model in Los Angeles, CA and Seattle, WA. Science of the Total Environment 2010;408(5):1120-1130. R831697 (2010)
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  • Supplemental Keywords:

    epidemiology, health effects, human health;, RFA, Scientific Discipline, Health, PHYSICAL ASPECTS, Air, particulate matter, Health Risk Assessment, Epidemiology, Risk Assessments, Biochemistry, Physical Processes, ambient aerosol, lung injury, long term exposure, lung disease, airway disease, exposure, airborne particulate matter, atherosclerosis, cardiovascular vulnerability, ambient particle health effects, human exposure, epidemiological studies, aersol particles, cardiovascular disease

    Relevant Websites:

    http://depts.washington.edu/mesaair

    Progress and Final Reports:

    Original Abstract
  • 2005 Progress Report
  • 2006 Progress Report
  • 2007 Progress Report
  • 2008 Progress Report
  • 2009 Progress Report
  • 2010 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • Final Report