2015 Progress Report: A Multi-City Time-Series Study of Pollutant Mixtures and Acute Morbidity

EPA Grant Number: R834799C004
Subproject: this is subproject number 004 , established and managed by the Center Director under grant R834799
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: The Southeastern Center for Air Pollution and Epidemiology: Multiscale Measurements and Modeling of Mixtures
Center Director: Tolbert, Paige
Title: A Multi-City Time-Series Study of Pollutant Mixtures and Acute Morbidity
Investigators: Sarnat, Stefanie Ebelt , Bilonick, Richard , Chang, Howard , Darrow, Lyndsey , Klein, Mitchel , Mulholland, James , Russell, Armistead G. , Talbott, Evelynn , Tolbert, Paige , Winquist, Andrea
Current Investigators: Sarnat, Stefanie Ebelt , Bilonick, Richard , Darrow, Lyndsey , Klein, Mitchel , Mulholland, James , Russell, Armistead G. , Talbott, Evelynn , Tolbert, Paige , Winquist, Andrea
Institution: Emory University , Georgia Institute of Technology , University of Pittsburgh
Current Institution: Emory University , Georgia Institute of Technology
EPA Project Officer: Chung, Serena
Project Period: January 1, 2011 through December 31, 2016
Project Period Covered by this Report: August 1, 2014 through July 31,2015
RFA: Clean Air Research Centers (2009) RFA Text |  Recipients Lists
Research Category: Health Effects , Air

Objective:

Although associations between ambient air pollution and acute cardiorespiratory outcomes have been observed in numerous studies, questions remain about the degree to which these findings are generalizable between locations and whether the observed health effects are due to the individual pollutants measured or to pollutants acting in combination with other pollutants. In Project 4, we are conducting a multi-city time-series study to clarify the impacts of air quality on acute cardiorespiratory morbidity in five U.S. cities (Atlanta, GA; Birmingham, AL; Dallas, TX; Pittsburgh, PA; and St. Louis, IL-MO) using novel mixture characterization metrics. Our overarching hypothesis is that factors related to air pollution mixtures, seasonality and climate, concentration-response functions, exposure measurement error, and population susceptibility and vulnerability can help explain apparent between-city heterogeneity in short-term associations between air quality measures and cardiorespiratory emergency department (ED) visits.

Progress Summary:

During the current reporting period, work on Project 4 has focused on remaining data acquisition activities as well as single- and multi-city epidemiologic analyses.

Database development. Database activities included acquisition of the remaining health outcome data for the study. Health outcome data for Atlanta, Birmingham, Dallas, and St. Louis are complete. In the past year, a subcontract with University of Pittsburgh collaborators was continued as planned. University of Pittsburgh collaborators have acquired and processed ED visit data from Pittsburgh-area hospitals; for sharing these data with Emory, data use agreements between Emory and relevant Pittsburgh-area hospitals were finalized. Data were transferred to Emory at the end of the current reporting period and will be incorporated into epidemiologic analyses moving forward.

Data analyses. A number of data analysis activities were conducted over the reporting period:

  1. We continued efforts on application of spatially-refined modeled estimates of ambient concentrations in multi-city epidemiologic analyses, including satellite-derived air quality estimates and the SCAPE data fusion approach, which combines monitoring and CMAQ modeled air quality data (Friberg, et al., submitted to ES&T), in health effect analyses and compared results with use of traditional monitoring-based exposure assignment approaches (Chang, et al., APHA, 2014; Sarnat, et al., ENV-VISION, 2015; Sarnat, et al., ISEE, 2015). Application of the different exposure metrics had a large impact on observed associations for NO2 and SO2, with stronger associations with use of data fusion exposure assignment approach, while associations for O3 and PM2.5 were largely similar across exposure assignment approaches. Results of these analyses also point to some consistency in estimated effects across four cities, such as strong positive associations of NO2 and PM2.5 with respiratory disease ED visits in all cities with no significant heterogeneity detected. Some heterogeneity in estimated effects across cities is also observed, such as strong positive associations for SO2 and respiratory ED visits in Birmingham and Dallas, but not in Atlanta or St. Louis; these findings are being further evaluated in multi-city effect modification analyses.
  2. With the Air Quality and Biostatistics Cores, we continued work on methods for detecting and analyzing air pollution mixtures using multi-pollutant monitoring data: a) an approach for using classification and regression trees (C&RT) in multi-city air pollution epidemiologic research was published (Gass, et al., 2015); b) our self-organizing maps approach to characterizing air pollution mixtures was published (Pearce, et al., 2014) and an extension of this approach for use in epidemiologic analyses was also published (Pearce, et al., 2015) and will be presented at ISEE (Pearce, et al., ISEE, 2015); c) our approach to estimating the joint effects of multiple pollutants previously published (Winquist, et al., 2014) is being incorporated along with other approaches to estimating the effects of pollutant groups (Ye, et al., ISEE, 2015); d) working with Project 1, we have continued our examination of the effect of reactive oxygen species (ROS) on cardiorespiratory ED visits by retrospectively predicting DTT activity using a prediction model developed based on Project 1 data; results suggest a strong association between DTT and ED visits that is independent of the effect of PM2.5 (Bates, et al., submitted to ES&T; Bates, et al., CMAS 2015 abstract pending, Bates, et al., AAAR, 2015); and finally e) we used source apportionment to estimate daily mass concentrations of PM2.5 by source type for four US cities, and for sources similar in chemical composition between cities, we estimated associations with respiratory disease ED visits (Krall, et al., submitted to EHP; Krall, et al. JSM, 2015). We found PM2.5 from mobile sources, biomass burning, and dust was similar in chemical composition between cities, but PM2.5 from coal combustion and metal sources varied across cities. We found evidence of positive associations of ED visits for respiratory disease with PM2.5 from biomass burning and little evidence of associations with PM2.5 from dust. Associations with PM2.5 from mobile sources were not consistent across cities.
  3. We continued work on examining detailed PM2.5 components data in epidemiologic analyses: a) analyses examining the health effects of a range of PM components from the St. Louis Supersite was published (Sarnat, et al., 2015); b) we applied and compared several approaches to estimating the effect of volatile organic compound chemical structure groups on cardiorespiratory ED visits in Atlanta (Ye, et al., ISEE, 2015); and c) we collaborated with the Biostatistics Core on a review article concerning statistical methods and challenges for estimating between PM components and health (Krall, et al., submitted to CEHR).
  4. We conducted preliminary multi-city analyses examining the shape of concentration-response functions using categorical pollution indicators.
  5. Finally, we assessed potential modifiers of the effects of ambient air pollution on health: a) multi-city analyses examining modification of air pollution-health associations by age were conducted and published for asthma (Alhanti, et al., accepted at JESEE) as well as for cardiovascular outcomes; b) analyses examining modification of air pollution-health associations by neighborhood socioeconomic factors were conducted for pediatric asthma/wheeze (O’Lenick, et al., submitted to JECH; O’Lenick, et al., SER 2015) as well as for cardiovascular outcomes; c) we continued work on estimating air exchange rates in each of the five cities and application of these data in epidemiologic models.

Future Activities:

Over the coming year, we anticipate completing our ED visit database by incorporating data from University of Pittsburgh collaborators. Manuscript preparation will begin and/or continue for analyses conducted over the past year. Current manuscripts in preparation include: 1) Exposure assignment considerations in a multi-city time-series study of ambient air pollution and cardiorespiratory emergency department visits; 2) Estimating the health effects of ambient volatile organic compounds; and 3) Relationship between warm-season ambient maximum temperature and emergency department visits across age groups. Additional planned manuscripts will focus on our multi-city assessment of air pollution and cardiovascular ED visits, further examination of retrospectively-predicted ROS on health, assessment of concentration-response function shape, assessment of air exchange rates as a modifier of ambient air pollution health effects, and extension of analyses considering modification of air pollution-health associations by neighborhood socioeconomic status to multiple cities.


Journal Articles on this Report : 31 Displayed | Download in RIS Format

Other subproject views: All 101 publications 43 publications in selected types All 42 journal articles
Other center views: All 334 publications 136 publications in selected types All 132 journal articles
Type Citation Sub Project Document Sources
Journal Article Alhanti BA, Chang HH, Winquist A, Mulholland JA, Darrow LA, Sarnat SE. Ambient air pollution and emergency department visits for asthma: a multi-city assessment of effect modification by age. Journal of Exposure Science & Environmental Epidemiology 2016;26(2):180-188. R834799 (2015)
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  • Journal Article Balachandran S, Pachon JE, Hu Y, Lee D, Mulholland JA, Russell AG. Ensemble-trained source apportionment of fine particulate matter and method uncertainty analysis. Atmospheric Environment 2012;61:387-394. R834799 (2012)
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  • Journal Article Bates JT, Weber RJ, Abrams J, Verma V, Fang T, Klein M, Strickland MJ, Sarnat SE, Chang HH, Mulholland JA, Tolbert PE, Russell AG. Reactive oxygen species generation linked to sources of atmospheric particulate matter and cardiorespiratory effects. Environmental Science & Technology 2015;49(22):13605-13612. R834799 (2015)
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  • Journal Article Baxter LK, Dionisio KL, Burke J, Sarnat SE, Sarnat JA, Hodas N, Rich DQ, Turpin BJ, Jones RR, Mannshardt E, Kumar N, Beevers SD, Ozkaynak H. Exposure prediction approaches used in air pollution epidemiology studies: key findings and future recommendations. Journal of Exposure Science & Environmental Epidemiology 2013;23(6):654-659. R834799 (2014)
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  • Journal Article Brown MS, Sarnat SE, DeMuth KA, Brown LAS, Whitlock DR, Brown SW, Tolbert PE, Fitzpatrick AM. Residential proximity to a major roadway is associated with features of asthma control in children. PLoS ONE 2012;7(5):e37044 ( pp.). R834799 (2012)
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  • Journal Article Chang HH, Hao H, Sarnat SE. A statistical modeling framework for projecting future ambient ozone and its health impact due to climate change. Atmospheric Environment 2014;89:290-297. R834799 (2014)
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  • Journal Article Darrow LA, Hess J, Rogers CA, Tolbert PE, Klein M, Sarnat SE. Ambient pollen concentrations and emergency department visits for asthma and wheeze. Journal of Allergy and Clinical Immunology 2012;130(3):630-638. R834799 (2012)
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  • Journal Article Dionisio KL, Isakov V, Baxter LK, Sarnat JA, Sarnat SE, Burke J, Rosenbaum A, Graham SE, Cook R, Mulholland J, Ozkaynak H. Development and evaluation of alternative approaches for exposure assessment of multiple air pollutants in Atlanta, Georgia. Journal of Exposure Science & Environmental Epidemiology 2013;23(6):581-592. R834799 (2014)
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  • Journal Article Dionisio KL, Baxter LK, Chang HH. An empirical assessment of exposure measurement error and effect attenuation in bipollutant epidemiologic models. Environmental Health Perspectives 2014;122(11):1216-1224. R834799 (2014)
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  • Journal Article Flanders WD, Klein M, Darrow LA, Strickland MJ, Sarnat SE, Sarnat JA, Waller LA, Winquist A, Tolbert PE. A method for detection of residual confounding in time-series and other observational studies. Epidemiology 2011;22(1):59-67. R834799 (2013)
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  • Journal Article Flanders WD, Klein M, Darrow LA, Strickland MJ, Sarnat SE, Sarnat JA, Waller LA, Winquist A, Tolbert PE. A method to detect residual confounding in spatial and other observational studies. Epidemiology 2011;22(6):823-826. R834799 (2012)
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  • Journal Article Friberg MD, Zhai X, Holmes HA, Chang HH, Strickland MJ, Sarnat SE, Tolbert PE, Russell AG, Mulholland JA. Method for fusing observational data and chemical transport model simulations to estimate spatiotemporally resolved ambient air pollution. Environmental Science & Technology 2016;50(7):3695-3705. R834799 (2016)
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  • Journal Article Gass K, Klein M, Chang HH, Flanders WD, Strickland MJ. Classification and regression trees for epidemiologic research: an air pollution example. Environmental Health 2014;13(1):17 (10 pp.). R834799 (2014)
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  • Journal Article Gass K, Klein M, Sarnat SE, Winquist A, Darrow LA, Flanders WD, Chang HH, Mulholland JA, Tolbert PE, Strickland MJ. Associations between ambient air pollutant mixtures and pediatric asthma emergency department visits in three cities: a classification and regression tree approach. Environmental Health 2015;14:58 (14 pp.). R834799 (2015)
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  • Journal Article Goldman GT, Mulholland JA, Russell AG, Strickland MJ, Klein M, Waller LA, Tolbert PE. Impact of exposure measurement error in air pollution epidemiology: effect of error type in time-series studies. Environmental Health 2011;10:61 (11 pp.). R834799 (2011)
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  • Journal Article Goldman GT, Mulholland JA, Russell AG, Gass K, Strickland MJ, Tolbert PE. Characterization of ambient air pollution measurement error in a time-series health study using a geostatistical simulation approach. Atmospheric Environment 2012;57:101-108. R834799 (2012)
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  • Journal Article Krall JR, Chang HH, Sarnat SE, Peng RD, Waller LA. Current methods and challenges for epidemiological studies of the associations between chemical constituents of particulate matter and health. Current Environmental Health Reports 2015;2(4):388-398. R834799 (2016)
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  • Journal Article Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. Associations between source-specific fine particulate matter and emergency department visits for respiratory disease in four U.S. cities. Environmental Health Perspectives 2017;125(1):97-103. R834799 (2016)
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  • Journal Article Maier ML, Balachandran S, Sarnat SE, Turner JR, Mulholland JA, Russell AG. Application of an ensemble-trained source apportionment approach at a site impacted by multiple point sources. Environmental Science & Technology 2013;47(8):3743-3751. R834799 (2013)
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  • Journal Article Pachon JE, Balachandran S, Hu Y, Mulholland JA, Darrow LA, Sarnat JA, Tolbert PE, Russell AG. Development of outcome-based, multipollutant mobile source indicators. Journal of the Air & Waste Management Association 2012;62(4):431-442. R834799 (2012)
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  • Journal Article Pachon JE, Weber RJ, Zhang X, Mulholland JA, Russell AG. Revising the use of potassium (K) in the source apportionment of PM2.5. Atmospheric Pollution Research 2013;4(1):14-21. R834799 (2014)
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  • Journal Article Pearce JL, Waller LA, Chang HH, Klein M, Mulholland JA, Sarnat JA, Sarnat SE, Strickland MJ, Tolbert PE. Using self-organizing maps to develop ambient air quality classifications: a time series example. Environmental Health 2014;13:56. R834799 (2014)
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  • Journal Article Pearce JL, Waller LA, Mulholland JA, Sarnat SE, Strickland MJ, Chang HH, Tolbert PE. Exploring associations between multipollutant day types and asthma morbidity: epidemiologic applications of self-organizing map ambient air quality classifications. Environmental Health 2015;14:55 (12 pp.). R834799 (2015)
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  • Journal Article Sarnat JA, Sarnat SE, Flanders WD, Chang HH, Mulholland J, Baxter L, Isakov V, Ozkaynak H. Spatiotemporally resolved air exchange rate as a modifier of acute air pollution-related morbidity in Atlanta. Journal of Exposure Science & Environmental Epidemiology 2013;23(6):606-615. R834799 (2013)
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  • Journal Article Sarnat SE, Sarnat JA, Mulholland J, Isakov V, Ozkaynak H, Chang HH, Klein M, Tolbert PE. Application of alternative spatiotemporal metrics of ambient air pollution exposure in a time-series epidemiological study in Atlanta. Journal of Exposure Science & Environmental Epidemiology 2013;23(6):593-605. R834799 (2014)
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  • Journal Article Sarnat SE, Winquist A, Schauer JJ, Turner JR, Sarnat JA. Fine particulate matter components and emergency department visits for cardiovascular and respiratory diseases in the St. Louis, Missouri-Illinois, metropolitan area. Environmental Health Perspectives 2015;123(5):437-444. R834799 (2015)
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  • Journal Article Strickland MJ, Darrow LA, Mulholland JA, Klein M, Flanders WD, Winquist A, Tolbert PE. Implications of different approaches for characterizing ambient air pollutant concentrations within the urban airshed for time-series studies and health benefits analyses. Environmental Health 2011;10:36 (9 pp.). R834799 (2011)
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  • Journal Article Winquist A, Klein M, Tolbert P, Sarnat SE. Power estimation using simulations for air pollution time-series studies. Environmental Health 2012;11:68 (12 pp.). R834799 (2012)
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  • Journal Article Winquist A, Klein M, Tolbert P, Flanders WD, Hess J, Sarnat SE. Comparison of emergency department and hospital admissions data for air pollution time-series studies. Environmental Health 2012;11:70 (14 pp.). R834799 (2012)
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  • Journal Article Winquist A, Kirrane E, Klein M, Strickland M, Darrow LA, Sarnat SE, Gass K, Mulholland J, Russell A, Tolbert P. Joint effects of ambient air pollutants on pediatric asthma emergency department visits in Atlanta, 1998-2004. Epidemiology 2014;25(5):666-673. R834799 (2014)
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  • Journal Article Winquist A, Schauer JJ, Turner JR, Klein M, Sarnat SE. Impact of ambient fine particulate matter carbon measurement methods on observed associations with acute cardiorespiratory morbidity. Journal of Exposure Science & Environmental Epidemiology 2015;25(2):215-221. R834799 (2014)
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  • Supplemental Keywords:

    ambient air, health effects, sensitive populations, dose-response, cumulative effects, epidemiology, exposure, air quality modeling, PM2.5, organics, elemental carbon, metals, oxidants, sulfates, source characterization, Health, Scientific Discipline, Health Risk Assessment, Risk Assessments, Biochemistry, Environmental Monitoring, particulate matter, children's health, morbidity, ambient air monitoring, climate change, air pollution, susceptibility, ambient particle health effects, airshed modeling, human health risk

    Relevant Websites:

    www.scape.gatech.edu Exit Exit

    Progress and Final Reports:

    Original Abstract
  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • 2014 Progress Report
  • Final Report

  • Main Center Abstract and Reports:

    R834799    The Southeastern Center for Air Pollution and Epidemiology: Multiscale Measurements and Modeling of Mixtures

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R834799C001 Development and Deployment of an Instrumentation Suite for Comprehensive Air Quality Characterization Including Aerosol ROS
    R834799C002 Examining In-Vehicle Pollution and Oxidative Stress in a Cohort of Daily Commuters
    R834799C003 Novel Estimates of Pollutant Mixtures and Pediatric Health in Two Birth Cohorts
    R834799C004 A Multi-City Time-Series Study of Pollutant Mixtures and Acute Morbidity