2013 Progress Report: A National Study to Assess Susceptibility, Vulnerability, and Effect Modification of Air Pollution Health Risks

EPA Grant Number: R834798C005
Subproject: this is subproject number 005 , established and managed by the Center Director under grant R834798
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Air Pollution Mixtures: Health Effects across Life Stages
Center Director: Koutrakis, Petros
Title: A National Study to Assess Susceptibility, Vulnerability, and Effect Modification of Air Pollution Health Risks
Investigators: Dominici, Francesca , Bell, Michelle L. , Schwartz, Joel , Zanobetti, Antonella
Institution: Harvard University , Yale School of Forestry & Environmental Studies
Current Institution: Harvard University
EPA Project Officer: Ilacqua, Vito
Project Period: January 1, 2011 through December 31, 2015 (Extended to December 31, 2016)
Project Period Covered by this Report: August 1, 2012 through July 31,2013
RFA: Clean Air Research Centers (2009) RFA Text |  Recipients Lists
Research Category: Health Effects , Air

Objective:

This National Study is aimed at identifying factors that explain the heterogeneity of health risks associated with air pollution exposure. We hypothesize that such factors include medical and social conditions, conditions that modify exposure, and differences in pollution composition that modify exposure toxicity. Moreover, we hypothesize that the relevant factors vary among different health outcomes. We will conduct national studies of short- and long-term exposures to individual pollutants, sources, and mixtures. We will establish a cohort of 2.3 million Medicare enrollees residing in Massachusetts and surrounding states and follow its members prospectively for cause-specific hospital admissions and mortality for the period 2000-2014, and also study all live births in Eastern MA, geo-coded to exact address and followed for adverse birth outcomes.

Progress Summary:

Epidemiological studies: We are making progress toward all the aims by conducting epidemiological studies and also by developing statistical methods. In Bell et al., we have reviewed recent literature to summarize the state of scientific evidence on effect modification and identify consistencies across studies. We focused on time series and case-crossover studies of the effects of short-term exposure to PM or O3 on mortality and morbidity. In Correia et al., we have conducted a nationwide epidemiological study on changes in PM2.5 in recent years and increase in life expectancy for 545 U.S. counties. In Kloog et al., we have further improved models to predict PM2.5 exposures at a finer spatial scale and at daily level for all the United States. In Kloog et al., we have conducted epidemiological studies to estimate acute and chronic effects of air pollution in both elderly, adults, and for pregnancy outcomes. In Bell et al., we have conducted an epidemiological study focused on an in-depth investigation of the effect of PM2.5 components and sources on the risk of hospital admissions in four counties in Connecticut. Finally, in Zanobetti et al., we have submitted for publication a paper that uses the Medicare data to estimate the short term effects of PM2.5 on mortality separately for Medicare enrollees that have had a previous hospitalization for diabetes or a neurological disorder.

Development of innovative statistical methods: In addition to conducting many epidemiological studies on particulate matter, its chemical composition and sources, the team has been very productive in developing new statistical methods. In Wang et al., we have developed a new approach that accounts for the uncertainty associated with the confounding adjustment in epidemiological studies of air pollution and health. This paper was favorably received by Dr. Thomas a member of the advisory board and we are now extending this work to nonlinear outcomes and to the case where we deal with multiple exposure variables. In Zigler et al., we have developed a new statistical approach aimed at assessing (using causal inference arguments), the effect of attainment versus not attainment status to the NAAQS for PM10, both on the levels of pollution (PM10 and O3) but also on the outcome (mortality). The statistical approach allows us to assess separately indirect and direct effects of air quality regulations on health outcomes. Finally in Bobb et al., we have developed a new class of Bayesian hierarchical models to estimating the joint effect associated with simultaneous exposure to more than one pollutant. We have applied this newly developed method to a multi-site time series study to estimate the joint effect of PM10 and ozone on mortality.

Future Activities:

There is a great amount of synergy and productivity among the members of the team. Below are summarized some examples. Matt Cefalu, a recently appointed postdoctoral fellow, and Itai Kloog, Schwartz and Dominici are conducting a study to better understand the role of confounders when some of these confounders are also used to predict exposure to air pollution. Kloog, Schwartz and Nordio are continuing to improve and refine exposure prediction models for fine particulate matter. Dominici is extending her previous work on PM2.5 and life expectance, by looking specifically at which components of PM2.5 are the main drivers of documented improvement in life expectancy. Zanobetti, Dominici, Bell and Bobb are all heavily involved in studies of climate change and health outcomes.

We will continue analysis of national short- and long-term exposures to individual pollutants, sources, and mixtures at a national scale. We will also continue development and analysis of a cohort of Medicare enrollees in Massachusetts and surrounding states for cause-specific hospital admissions and mortality; studying all live births in Eastern MA, geo-coded to exact address and followed for adverse birth outcomes.


Journal Articles on this Report : 10 Displayed | Download in RIS Format

Other subproject views: All 60 publications 59 publications in selected types All 59 journal articles
Other center views: All 359 publications 297 publications in selected types All 297 journal articles
Type Citation Sub Project Document Sources
Journal Article Bell ML, Zanobetti A, Dominici F. Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis. American Journal of Epidemiology 2013;178(6):865-876. R834798 (2013)
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  • Journal Article Bell ML, Ebisu K, Leaderer BP, Gent JF, Lee HJ, Koutrakis P, Wang Y, Dominici F, Peng RD. Associations of PM2.5 constituents and sources with hospital admissions:analysis of four counties in Connecticut and Massachusetts (USA) for persons ≥ 65 years of age. Environmental Health Perspectives 2014;122(2):138-144. R834798 (2013)
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  • Journal Article Bobb JF, Dominici F, Peng RD. Reduced hierarchical models with application to estimating health effects of simultaneous exposure to multiple pollutants. Journal of the Royal Statistical Society: Series C (Applied Statistics) 2013;62(3):451-472. R834798 (2012)
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  • Journal Article Correia AW, Pope III CA, Dockery DW, Wang Y, Ezzati M, Dominici F. Effect of air pollution control on life expectancy in the United States: an analysis of 545 U.S. counties for the period 2000 to 2007. Epidemiology 2013;24(1):23-31. R834798 (2012)
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  • Journal Article Kloog I, Coull BA, Zanobetti A, Koutrakis P, Schwartz JD. Acute and chronic effects of particles on hospital admissions in New-England. PLoS ONE 2012;7(4):e34664. R834798 (2012)
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  • Journal Article Kloog I, Melly SJ, Ridgway WL, Coull BA, Schwartz J. Using new satellite based exposure methods to study the association between pregnancy PM2.5 exposure, premature birth and birth weight in Massachusetts. Environmental Health 2012;11:40 (8 pp.). R834798 (2012)
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  • Journal Article Kloog I, Nordio F, Coull BA, Schwartz J. Incorporating local land use regression and satellite aerosol optical depth in a hybrid model of spatiotemporal PM2.5 exposures in the Mid-Atlantic states. Environmental Science & Technology 2012;46(21):11913-11921. R834798 (2013)
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  • Journal Article Kloog I, Ridgway B, Koutrakis P, Coull BA, Schwartz JD. Long-and short-term exposure to PM2.5 and mortality: using novel exposure models. Epidemiology 2013;24(4):555-561. R834798 (2013)
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  • Journal Article Wang C, Parmigiani G, Dominici F. Bayesian effect estimation accounting for adjustment uncertainty. Biometrics 2012;68(3):661-671. R834798 (2012)
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  • Journal Article Zigler CM, Dominici F, Wang Y. Estimating causal effects of air quality regulations using principal stratification for spatially correlated multivariate intermediate outcomes. Biostatistics 2012;13(2):289-302. R834798 (2012)
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  • Supplemental Keywords:

    National studies, air pollution, heterogeneity, vulnerability, susceptibility, Scientific Discipline, Air, air toxics, Health Risk Assessment, Air Pollution Effects, Biochemistry, Biology, ambient air quality, complex mixtures, health effects, sensitive populations, children's health, air pollutants, biological sensitivities, exposure and effects, lung epithelial cells, susceptible populations, chemical composition, neurotoxicity, toxicity, coronary artery disease, cardiopulmonary, cardiotoxicity, environmental effects, mortality, human health

    Progress and Final Reports:

    Original Abstract
    2010 Progress Report
    2011 Progress Report
    2012 Progress Report
    2014 Progress Report
    Final Report


    Main Center Abstract and Reports:

    R834798    Air Pollution Mixtures: Health Effects across Life Stages

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R834798C001 Relative Toxicity of Air Pollution Mixtures
    R834798C002 Cognitive Decline, Cardiovascular Changes, and Biological Aging in Response to Air Pollution
    R834798C003 Identifying the Cognitive and Vascular Effects of Air Pollution Sources and Mixtures in the Framingharn Offspring and Third Generation Cohorts
    R834798C004 Longitudinal Effects of Multiple Pollutants on Child Growth, Blood Pressure and Cognition
    R834798C005 A National Study to Assess Susceptibility, Vulnerability, and Effect Modification of Air Pollution Health Risks