Grantee Research Project Results

2004 Progress Report: Chronic and Acute Exposure to Ambient Fine Particulate Matter and Other Air Pollutants: National Cohort Studies of Mortality and Morbidity

EPA Grant Number: R830548
Title: Chronic and Acute Exposure to Ambient Fine Particulate Matter and Other Air Pollutants: National Cohort Studies of Mortality and Morbidity
Investigators: Samet, Jonathan M. , Louis, Thomas A. , Zeger, Scott L. , Parent, Stephen T. , McDermott, Aidan , Geyh, Alison , Dominici, Francesca , Wyant, Timothy
Current Investigators: Samet, Jonathan M.
Institution: The Johns Hopkins University , Health Systems Innovations , Decipher
Current Institution: The Johns Hopkins University , Decipher , Health Systems Innovations
EPA Project Officer: Chung, Serena
Project Period: February 1, 2003 through January 31, 2006 (Extended to January 31, 2007)
Project Period Covered by this Report: February 1, 2004 through January 31, 2005
Project Amount: $1,033,646
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: Particulate Matter , Air Quality and Air Toxics , Human Health , Air

Objective:

The objective of this research project is to address a key uncertainty in the evidence on the effects of particulate matter (PM) on public health: the effects of long-term exposure to airborne PM, including PM_2.5, on morbidity and mortality. By using large, existing cohorts established by federal agencies, we will:

1. test the hypothesis that long-term exposure to PM increases mortality and morbidity;
2. explore whether any effect of PM varies with levels of other pollutants;
3. and compare risks of exposure to PM in persons with and without underlying heart and lung disease.

The focus of our analysis will be on the longitudinal data in the National Medicare Cohort, comprising over 27 million Medicare participants living within 10 miles of a PM_2.5 monitor and tracked for hospitalization and death. Outpatient visits are available for a 5 percent sample. We have data for 1999-2002 with approximately 800,000 deaths annually. We will use hospitalization data to construct comorbidity measures. A separate smaller survey, the Medicare Current Beneficiary Survey (MCBS), provides information on a large number of potential confounding factors. We also will explore the use of the Veterans Health Study Cohort, which includes 900,000 persons. Data on hospitalization and mortality from these cohorts will be combined with weather data and the air monitoring data routinely collected by the U.S. Environmental Protection Agency (EPA). Over the 3 years of the project, we will obtain data and create the analytic data base, address methodological issues related to imputation of potential confounding factors, and estimate the acute and chronic effects of PM_2.5 and other pollutants on morbidity and mortality, including characterizing effects on differing timescales and regions of the country.

We have identified epidemiologic cohorts that can provide reasonably precise estimates of the health risks posed by PM_2.5 and other pollutants. The cohorts will provide sufficient events to directly address risks of PM_2.5 without using surrogate indicators. The data will offer insights into cardiac and respiratory comorbidity as a determinant of susceptibility and into the differing magnitudes of risks found in the time-series and cohort studies of PM. The findings will advance understanding of the public health consequences of air pollution and support the development of more certain risk models for air pollution and health.

Progress Summary:

During Year 1 of the project, emphasis was placed on obtaining the above data sets, integrating them into an analytic file, and beginning to develop the methods for the data analysis. We have obtained the Medicare data, including the full Part B data set, the 5 percent sample data for Part A, and the MCBS data. Analytic data sets were created. We now have completed initial, cross-sectional analyses of mortality and PM_2.5 across 300 counties. Time-series analyses of hospitalizations are in progress.

Future Activities:

Because the large cohorts used in this project include daily data, we will apply methods for time-series analysis to compare the effect of PM on time scales ranging from daily to yearly. We also will explore spatial variation of the effects of PM and other pollutants and will establish a protocol for the ongoing use of these studies for tracking the public health risks of air pollution. Initial emphasis to date was placed on obtaining substantial raw data and developing analytical files. We have now moved forward to address study hypotheses using this extraordinarily rich data resource. The scope of the cohort shows the potential of the study population for addressing the overall goals of the original Science To Achieve Results (STAR) application and characterizing the short-term and long-term effects of PM on morbidity and mortality. We expect to bring a number of analyses to completion over the next 6 months, particularly those directed at PM_2.5 mortality by county. The findings should prove informative to EPA as it continues to develop the base of scientific evidence needed for support of the National Ambient Air Quality Standard for PM. The general approach of using the Centers for Medicare and Medicaid Services data may prove to be a useful model for investigating the effects of other environmental agents on elderly and other vulnerable populations.

Journal Articles:

No journal articles submitted with this report: View all 12 publications for this project

Supplemental Keywords:

ambient air, health effects, epidemiology, air, human health, susceptibility, sensitive population, particulate matter, PM, acute health effects, acute cardiovascular effects, acute exposure, air pollution, air quality, cardiovascular disease, chronic health effects, fine particles, human exposure, inhaled pollutants, long-term exposure, morbidity, mortality, particulate exposure, susceptible subpopulations, time-series analysis,, RFA, Health, Air, Scientific Discipline, PHYSICAL ASPECTS, HUMAN HEALTH, Susceptibility/Sensitive Population/Genetic Susceptibility, Health Risk Assessment, Physical Processes, Risk Assessments, particulate matter, Environmental Chemistry, Exposure, Epidemiology, air toxics, inhaled, air quality, environmental hazard exposures, inhaled pollutants, sensitive populations, fine particles, lung inflammation, long term exposure, acute lung injury, human exposure, mortality, cardiopulmonary responses, particulate exposure, National Cohort Studies, morbidity, Acute health effects, airway epithelial cells, copollutant exposures, cardiac arrest, cardiotoxicity, acute exposure, chronic health effects, susceptible subpopulations, concentrated particulate matter, air contaminant exposure, toxics, atmospheric particulate matter, air pollution, human susceptibility, acute cardiovascular effects, airborne urban contaminants, cardiovascular disease, cardiopulmonary, human health risk, time series analysis, PM 2.5

Relevant Websites:

http://www.biostat.jhsph.edu/bstproj/ebeg/data.php Exit
http://www.ihapss.jhsph.edu Exit

Progress and Final Reports:

Original Abstract

2003 Progress Report

2005 Progress Report

Final Report