Grantee Research Project Results
2010 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 , 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, 2009 through November 30,2010
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 the New York City Department of Health and Mental Hygiene (NYCDOHMH). We systematically characterize the sequence of events among weather conditions, air pollution buildup, and health effects indicators. Using sub-area analysis, we also determine spatial and neighborhood/socio-economic factors that influence the prediction power and efficiency of the models. We estimate model uncertainties by computing prediction errors of candidate models in a series of real-time validation tests. Overall, this project aims to create a framework to model, in 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). 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 the Department of Health and Mental Hygiene (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: 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 and 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: The result from this analysis has been recently published (Mathes et al., 2011). 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 submitted and is currently under review. 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 is 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. We fit generalized linear models to assess the relationships of daily counts of heat-related EMS and ED visits to natural cause deaths after adjustment for weather conditions during the months of May-September between 1999 and 2008. Controlling for temporal trends, an 11% (95% confidence interval (CI): 5-18) and 7% (95% CI: 4-9) increase in natural cause mortality was associated with an increase from the 50th percentile to 99th percentile of same-day and 1-day lagged heat-related EMS calls and ED visits, respectively. After controlling for both temporal trends and weather, we observed a 10% (95% CI: 4-16) increase in natural cause mortality associated with 1-day lagged heat-related EMS calls and a 5% mortality increase with 1-day lagged ED visits (95% CI: 2-8). Heat-related illness can be tracked during heat waves using EMS and ED data, which are indicators of heat-associated excess natural cause mortality during the warm weather season. Thus, heat-related morbidity indicators can predict mortality above and beyond weather variables.
Particulate Matter Source Types Associated with Cardiovascular Hospitalizations and Mortality: The result of this analysis has been recently published (Ito et al., 2011). Recent time-series studies have indicated that both cardiovascular disease (CVD) mortality and hospitalizations were associated with particulate matter (PM). However, seasonal patterns of PM associations with these outcomes are not consistent, and PM components responsible for these associations have not been determined. We investigated this issue in NYC, where PM originates from regional and local combustion sources. In this study, we examined the role of PM2.5 chemical components on both CVD hospitalizations and on mortality in NYC. We analyzed daily deaths and emergency hospitalizations for cardiovascular diseases (CVDs) among those persons ≥ aged 40 years of age for their associations with PM2.5, its chemical components, nitrogen dioxide (NO2), carbon monoxide, and sulfur dioxide for the years 2000–2006 using a Poisson model adjusting for temporal and seasonal trends, temperature effects, and day of the week. We estimated excess risks per inter-quartile-range increases at lags 0 through 3 days for warm (April–September) and cold (October–March) seasons. The CVD mortality series exhibits strong seasonal trends, whereas the CVD hospitalization series shows a strong day-of-week pattern. These outcome series were not correlated with each other but were individually associated with a number of PM2.5 chemical components from regional and local sources, each with different seasonal patterns and lags. Local combustion sources, including traffic and residual oil burning, may play a year- round role in the associations between air pollution and CVD outcomes, but transported aerosols may explain the seasonal variation in associations shown by PM2.5 mass.
Future Activities:
In the last (extended) year of this project, we will: (1) publish the portions of the results described above that have not been published; and (2) write and publish a manuscript that describes/compares the prediction models of various health outcomes examined in this study.
Journal Articles on this Report : 3 Displayed | Download in RIS Format
Other project views: | All 7 publications | 4 publications in selected types | All 4 journal articles |
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Ito K, Mathes R, Ross Z, Nadas A, Thurston G, Matte T. Fine particulate matter constituents associated with cardiovascular hospitalizations and mortality in New York City. Environmental Health Perspectives 2011;119(4):467-473. |
R833623 (2010) R833623 (Final) |
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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.