2012 Progress Report: The Effect of Air Pollution Control on Life Expectancy in the United States: A Population-Based Analysis of Major Metropolitan Areas

EPA Grant Number: R834894
Title: The Effect of Air Pollution Control on Life Expectancy in the United States: A Population-Based Analysis of Major Metropolitan Areas
Investigators: Dominici, Francesca , Dockery, Douglas W. , Ezzati, Majid , Pope, Clive Arden
Institution: Harvard T.H. Chan School of Public Health , Brigham Young University , Imperial College , The Johns Hopkins University
Current Institution: Harvard T.H. Chan School of Public Health , Brigham Young University , Imperial College
EPA Project Officer: Ilacqua, Vito
Project Period: July 1, 2011 through June 30, 2013 (Extended to June 30, 2014)
Project Period Covered by this Report: July 1, 2011 through June 30,2012
Project Amount: $300,000
RFA: Exploring New Air Pollution Health Effects Links in Existing Datasets (2010) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Air

Objective:

Over the past few decades, there have been substantial and measurable improvements in ambient air quality in the United States (U.S.). There also have been improvements in population survival, primarily as a result of decline in cardiovascular disease (CVD) mortality, although the change in life expectancy has been highly variable across U.S. counties. Given the differential changes in air pollution and life expectancy, we propose to conduct analyses that will directly estimate the benefits of lower air pollution on survival, adjusting for temporal trends in other key predictors of mortality. The proposed study brings together an experienced multi-disciplinary team of investigators with the objective of determining quantitatively the impacts of trends in selected criteria pollutants on cause-specific mortality and life expectancy in a population-based study. Our specific aims are:

A.1. To estimate the effects of trends in measured PM2.5 (fine PM or particulate matter with an aerodynamic diameter less than or equal to 2.5 mm), PM10 (inhalable PM or particulate matter with an aerodynamic diameter less than or equal to 10 mm), PM10-2.5 (coarse PM or particulate matter with an aerodynamic diameter greater than 2.5 mm and less than or equal to 10 mm), PM2.5 constituents, ozone, and sulfur dioxide (SO2) on cardiopulmonary mortality for the several hundred U.S. counties with measurement data between 1999 and 2008.
 
A.2. To estimate the resulting effects of changes in cardiopulmonary mortality associated with air pollution trends on life expectancy at birth in the same counties. Given the potentially large costs of implementing policy efforts to reduce air pollution, there is a growing need for research that demonstrates the health improvements associated with these efforts. This proposed research will provide essential new knowledge on the nationwide health benefits of reducing air pollution. The results as well as the data sources and methods will be innovative and contribute to strengthening air pollution research.

Progress Summary:

In year 1 we have made important contributions in the following areas:
 
1) Methods development: We have developed statistical methods to adjust for measured and unmeasured confounding in air pollution studies (Wang, et al., Biometrics 2012). We also have developed methods for the analysis of large spatio-temporal data to estimate the association between long-term trends in PM2.5 and trends in mortality in the Medicare cohort (Greven, et al., JASA 2011). Finally, we are developing statistical methods for causal inference to assess the public health impact of air quality regulations (Zigler, et al., Biostatistics 2012).
 
2) Epidemiological studies: One of the most important papers for year 1 by Correia, et al., directly addresses Aims 1 and 2 of this grant for PM2.5. This paper has been accepted for publication in Epidemiology; Jonathan M. Samet is writing a commentary and there will be a press release. The abstract is below.
 
Abstract: In recent years (2000 to 2007), ambient levels of fine particulate matter (PM2.5) have continued to decline as a result of interventions, but the decline has been at a slower rate than previous years (1980 to 2000). Whether these more recent and slower declines of PM2.5 levels continue to improve life expectancy and whether they benefit all populations equally is unknown. We assembled a dataset for 545 U.S. counties consisting of yearly county-specific average PM2.5, yearly county-specific life expectancy, and several potentially confounding variables measuring socioeconomic status, smoking prevalence and demographic characteristics for the years 2000 and 2007. We used regression models to estimate the association between reductions in PM2.5 and changes in life expectancy for the period 2000 to 2007. A decrease of 10 mg/m3 in the concentration of PM2.5 was associated with an increase in mean life expectancy of 0.35 years SD = 0.16 years, p = 0.033). This association was stronger in more urban and densely populated counties. Reductions in PM2.5 were associated with improvements in life expectancy for the period 2000 to 2007. Air pollution control in the last decade has continued to have a positive impact on public health.
 
In addition, we have published a large epidemiological study on the effect of county-wide smoking bans and long-term changes in hospital admissions for cardiovascular diseases (Barr, et al., 2012). We have conducted another nationwide “pattern of care” study to investigate whether hospitalization for cardiovascular diseases (CVD), CVD-specific mortality, and use of CVD-specific in-hospital procedures have been changing over the last decade and across the United States in the last decade (Barr, et al., AJE 2012). We also have been invited to write an editorial for JAMA to describe challenges with the investigation of the public health benefits of air quality interventions, in this case the Olympic Games in China.

Future Activities:

In the second year, we plan to continue to work on methodological development geared toward multiple pollutant analyses and methods for causal inference; we also plan to extend the work in Correia, et al., to multiple pollutants.


Journal Articles on this Report : 8 Displayed | Download in RIS Format

Other project views: All 43 publications 31 publications in selected types All 31 journal articles
Type Citation Project Document Sources
Journal Article Barr CD, Diez DM, Wang Y, Dominici F, Samet JM. Comprehensive smoking bans and acute myocardial infarction among Medicare enrollees in 387 US counties: 1999–2008. American Journal of Epidemiology 2012;176(7):642-648. R834894 (2012)
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  • Journal Article Dominici F, Mittleman MA. China’s air quality dilemma:reconciling economic growth with environmental protection. Journal of the American Medical Association 2012;307(19):2100-2102 (editorial). R834894 (2012)
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  • Journal Article Greven S, Dominici F, Zeger S. An approach to the estimation of chronic air pollution effects using spatio-temporal information. Journal of the American Statistical Association 2011;106(494):396-406. R834894 (2012)
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  • Abstract: Taylor & Francis-Abstract
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  • Journal Article Levy JI, Diez D, Dou Y, Barr CD, Dominici F. A meta-analysis and multisite time-series analysis of the differential toxicity of major fine particulate matter constituents. American Journal of Epidemiology 2012;175(11):1091-1099. R834894 (2012)
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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. R834894 (2012)
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  • Journal Article Wang C, Parmigiani G, Dominici F. Rejoinder: Bayesian effect estimation accounting for adjustment uncertainty. Biometrics 2012;68(3):680-686. R834894 (2012)
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  • Abstract: Wiley-Original Article Preview
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  • Journal Article Yeh RW, Normand S-LT, Wang Y, Barr CD, Dominici F. Geographic disparities in the incidence and outcomes of hospitalized myocardial infarction:does a rising tide lift all boats? Circulation: Cardiovascular Quality and Outcomes 2012;5(2):197-204. R834894 (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. R834894 (2012)
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  • Supplemental Keywords:

    Life expectancy, PM2.5, trends, confounding

    Progress and Final Reports:

    Original Abstract
    2013 Progress Report
    Final Report