Grantee Research Project Results
2009 Progress Report: Near Real Time Modeling of Weather, Air Pollution, and Health Outcome Indicators in New York City
EPA Grant Number: R833623Title: Near Real Time Modeling of Weather, Air Pollution, and Health Outcome Indicators in New York City
Investigators: Ito, Kazuhiko , Thurston, George D. , Nadas, Arthur , Metzger, Kristina , Mathes, Robert , Matte, Thomas
Current Investigators: Ito, Kazuhiko , Thurston, George D. , Nadas, Arthur , Matte, Thomas
Institution: New York University School of Medicine , New York City Department of Health and Mental Hygiene
EPA Project Officer: Hahn, Intaek
Project Period: December 1, 2007 through November 30, 2010 (Extended to November 30, 2011)
Project Period Covered by this Report: December 1, 2008 through November 30,2009
Project Amount: $494,552
RFA: Development of Environmental Health Outcome Indicators (2006) RFA Text | Recipients Lists
Research Category:
Objective:
The objective of this project is to develop models to predict acute respiratory morbidity (including asthma exacerbation) using near-real time weather, ambient air pollution, and respiratory emergency department (ED) visits in New York City (NYC). We take advantage of a unique syndromic surveillance system that monitors ED visits daily by NYCDOHMH. We will systematically characterize the sequence of events among weather conditions, air pollution buildup, and health effects indicators. Using sub-area analysis, we will also determine spatial and neighborhood/socio-economic factors that influence the prediction. Overall, this project will create a framework to model, in near real time, acute health outcome indicators of environmental exposures in a large metropolitan area.Progress Summary:
Impact of heat wave on mortality: The manuscript of analysis has been recently published (Metzger, Ito, and Matte, 2010, see publications). We evaluated model performance for an exhaustive set of alternative weather models, using both parametric and non-parametric time-series Poisson models, to predict the heat wave effects on natural mortality. The fitted heat index/mortality relationship showed a non-linear relationship, with a steeper slope above a 100 degrees HI. These findings have been communicated to the Office of Emergency Management, and subsequently DOHMH formally recommended that these agencies modify the threshold for heat advisories and activating a response. Thus, our research project contributed to the improvement of a public health program in New York City.
Within-city effect modifiers of short-term air pollution effects: This analysis was presented at the 21st Annual meeting of International Society of Environmental Epidemiology (ISEE), in Dublin, Ireland, August 2009. A manuscript is in preparation. We used NYCDOHMH near-real-time syndromic illness surveillance data on daily emergency departments (ED) visits to evaluate the extent to which neighborhood characteristics modify the temporal relation of asthma to ambient air quality. Daily asthma ED syndromic illness counts for children (age 5 – 17) during the years 2002-2006 were analyzed for their associations with fine particles (PM2.5), nitrogen dioxide, and ozone. Zip code specific Poisson regression models adjusted for temporal trends, immediate and delayed temperature, and day of week. In the second stage model, traffic density was the most significant effect modifier of the PM2.5-asthma association. This examination of the within-city variation of air pollution effects and the role of effect modifiers is one of our major goals of this project, and is a new and relevant contribution to this field.
Assessing syndromic surveillance of cardiovascular outcomes from emergency department chief complaint data in New York City: A manuscript of this analysis has been recently submitted. Given the reported associations between air pollution/weather and cardiovascular outcomes, we have developed cardiovascular ED syndromic data based on the chief complaint data field. We developed text-processing algorithms based on sensitivity, specificity, and positive predictive value to chief complaint data reported electronically by a sample of 11 New York City emergency departments for which ICD-9 discharge diagnosis codes were available. Based on this model, we evaluated the consistency of daily temporal variation of cardiovascular ED syndromic counts and hospitalizations. An overall strong day of week pattern and weak seasonal trend were observed for both cardiovascular ED syndromic and hospitalization time-series. These time-series were highly correlated after removing the day of week, holiday, and seasonal trends. Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity.
The association of peaks in daily tree pollen concentration and allergy medication sales in New York City: A manuscript of this analysis has been written and about to be submitted. This analysis has been conducted in collaboration with the researchers from Columbia University Mailman School of Public Health (Patrick Kinney and Kate Weinberger), Mount Sinai School of Medicine (Perry Sheffied), and Louis Calder Center, Fordham University (Guy Robinson). As part of the syndromic surveillance data, NYCDOH keeps track of over-the-counter (OTC) allergy medication sales in NYC. Dates of select peak tree pollen concentrations were obtained from a primary New York City monitoring station for the years 2003-2008. Time series models were fit with the logarithm of daily allergy medication sales reported to the city health department as a function of the same-day and lagged binary tree pollen peak indicators, adjusting for season, year-to-year variation, temperature, and day-of-week. Significant associations were found between the tree pollen peaks and allergy medication sales, with the strongest association at 2-day lag. Improved public health advisories and more specific pollen season charts will be possible with further refinement of exposure metrics and additional health outcomes.
Real-time surveillance of heat-related morbidity: reflection of heat wave severity:
A draft manuscript of this analysis has been written and being revised. In this study, we explored the association between heat-related ambulance calls and ED visits and natural cause mortality. Heat-related calls to the emergency medical system (EMS) and heat-related visits to ED in New York City are tracked by syndromic surveillance systems maintained by the NYCDOH. We combined data on natural cause mortality and heat-related EMS calls and ED visits in New York City between 1999 and 2008. Natural cause mortality was associated non-linearly with one-day lagged heat-related EMS calls after a threshold of 20 calls and linearly with one-day lagged ED visits. These data suggest heat-related calls to the EMS system and heat-related visits to the ED may be helpful in predicting natural cause mortality during the warm weather season.
Particulate matter source types associated with cardiovascular hospitalizations and mortality: The result of this analysis is being presented at a specialty conference by the American Association for Aerosol Research (AAAR), March 22-26, 2010, San Diego, CA. A manuscript also is in preparation. We investigated association between air pollution and cardiovascular (CVD) mortality and hospitalizations in New York City, where both regional and local combustion sources impact. The short-term associations between the CVD outcomes and PM2.5, its chemical components, and gaseous pollutants were examined using Poisson time-series model adjusting for temporal trends/seasonal cycles, immediate and delayed temperature effects, and day-of-week. Among the PM2.5 chemical components, the species originated from both regional secondary aerosols (e.g., sulfate) and local combustion (e.g., elemental carbon) were associated with CVD mortality in the warm season, whereas for CVD hospitalizations, those originated from local sources (e.g., elemental carbon, Zn, Si) showed associations in the cold season. Apparent modification by season and source type of the relations of PM to CVD mortality and hospitalizations merits further study to examine potential differences in at-risk subpopulations.
Future Activities:
In the last year of this project, we will focus on final assessment of prediction models of various health outcomes that we have examined, and will prepare/submit manuscripts of all the analyses we conducted.Journal Articles on this Report : 2 Displayed | Download in RIS Format
Other project views: | All 7 publications | 4 publications in selected types | All 4 journal articles |
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Mathes RW, Ito K, Matte T. Assessing syndromic surveillance of cardiovascular outcomes from emergency department chief complaint data in New York City. PLoS One 2011;6(2):e14677. |
R833623 (2009) R833623 (2010) R833623 (Final) |
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Metzger KB, Ito K, Matte TD. Summer heat and mortality in New York City: how hot is too hot? Environmental Health Perspectives 2010;118(1):80-86. |
R833623 (2009) R833623 (2010) R833623 (Final) |
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Supplemental Keywords:
weather, air pollution, asthmaProgress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.