Grantee Research Project Results
2000 Progress Report: Health Effects of long-Term Exposure to Particles and Other Air Pollutants in Elderly Nonsmoking California Residents
EPA Grant Number: R827998Title: Health Effects of long-Term Exposure to Particles and Other Air Pollutants in Elderly Nonsmoking California Residents
Investigators: Knutsen, Synnove F. , Abbey, David E. , Beeson, Larry
Institution: Loma Linda University
EPA Project Officer: Chung, Serena
Project Period: March 1, 2000 through February 28, 2003 (Extended to February 28, 2005)
Project Period Covered by this Report: March 1, 2000 through February 28, 2001
Project Amount: $763,910
RFA: Airborne Particulate Matter Health Effects (1999) RFA Text | Recipients Lists
Research Category: Particulate Matter , Air , Human Health
Objective:
The primary objective of this project is to determine the risk of long-term concentrations of PM2.5 on all-cause mortality and nonmalignant respiratory mortality as well as lung cancer and cardiovascular disease incidence and mortality using data from a cohort of 6,338 nonsmoking California Seventh-day Adventists who have been followed prospectively since 1977.The secondary objectives are to: (1) assess the health effects of long-term concentrations of other air pollutants (PM10, PM10-2.5, SO4, SO2, O3, NO2) on the same outcomes as mentioned for the primary objective; (2) assess the health effects of mixed pollutants; (3) assess the health effects of long-term concentrations of all the mentioned air pollutants using multipollutant analysis; and (4) evaluate the health effects of air pollutants in sensitive subgroups.
Progress Summary:
The focus of the first year was to obtain updated exposure and outcome information from all participants.Tracing
Followups were attempted on all persons in the AHSMOG cohort who were alive at the last full followup in 1992. Because some of the persons in the cohort were deceased, a total of 4,103 questionnaires were sent out. As of May 11, 2001, tracing was completed with a response rate of 87 percent. Because of the cohort's longevity, we believe that is an excellent response rate.
Mortality was assessed by linkage with the National Death Index and by obtaining death certificates from those identified as probably part of the AHSMOG cohort. All relevant death certificates were requested, but to date, only 55 percent of them have been returned by the different states around the country. We anticipate that the remaining death certificates will be received within the next few months.
Surrogate interviews have been done with a close friend or relative of those who are deceased, and this process will continue through the summer of 2001.
Methods used for tracing include the following:
- Telephone calls to last known address.
- Telephone calls to the person identified by the participant as "always knowing their whereabouts."
- Department of Motor Vehicle (DMV) information.
- Mailing list for church paper.
- Church clerks.
Methods used for assessing deaths include:
- Information from spouse, close friend, church clerk, etc.
- Record linkage with National Death Index tapes.
- Obtaining death certificates from the state in which the person died.
Estimates of Ambient Air Pollution
PM2.5 visibility data and directly monitored data have been received from California, and we are in the process of calculating the individual exposure measures using the same methodology as before.
Other Pollutants?Sonoma Technologies, which processes the information that is collected by the California Air Resources Board (CARB), will provide us with ambient levels of air pollutants (PM10, O3, SO2, NO2, SO4) by zip code through March 2000. We should receive this information sometime during the summer of 2001. Since 1992, several air monitoring stations have been discontinued and others have been activated. This creates a challenge of developing new algorithms for assessing individual exposure. The new algorithms will be compared with those used in the past to assure that they are compatible. When the zip code-specific ambient air pollution levels become available, we will be able to link them to the individuals in our cohort by using the new algorithms for assessing individual exposure to ambient air pollutants.
Assessment of Outcome
Mortality outcomes are being updated as death certificates are obtained. All death certificates are being coded by a nosologist. As mentioned below, tracing has taken more time than anticipated. As of May 2001, we had death certificates for about 50 percent of those known to be deceased.
When all surrogate information has been collected?by the end of summer 2001?the assessment of incident cancer will be done. At that point, there will be a file merge with the California Cancer Registry. For those living out of state, medical histories will be obtained from the hospital given by the participant as the place of diagnosis of their cancer.
Progress
Tracing the cohort participants, who had not been contacted since 1993, was more challenging than expected and took longer than anticipated. The consultant meeting that was scheduled for the first year?when tracing was completed?has not taken place. It will be conducted sometime during early fall 2001. However, we are doing the preparation for the air pollution estimations in parallel so that the overall timing of the study is on target.
Future Activities:
Year 2 will consist of completing surrogate questionnaires for those deceased, obtaining monthly and individual data on exposure to ambient air pollutants since 1992, updating cancer incidence through record linkage with the California Cancer Registry, and obtaining medical history charts for out-of-state cases.During Year 2, we also will develop individual estimates of exposure to ambient air pollutants and expect to do the first analysis of risk of defined outcomes in relation to these exposures. We will focus on the following endpoints: all cause mortality, nonmalignant respiratory mortality, and lung cancer and cardiovascular incidence and mortality. These analyses should result in abstracts and publications by spring 2002.
In Year 3 (final year), we will do the final analysis and writeup. We will study the health effects of mixed pollutants and the risk of the specified outcomes in sensitive subgroups. We also expect to analyze the risk of the different outcomes using multipollutant models. We expect several publications resulting from this work.
Journal Articles:
No journal articles submitted with this report: View all 19 publications for this projectSupplemental Keywords:
ambient air, ozone, exposure, risk, risk assessment, health effects, human health, sensitive populations, carcinogen, population, elderly, cumulative effects, susceptibility, epidemiology, modeling, monitoring, analytical, southwest, California, CA., RFA, Scientific Discipline, Health, Air, ENVIRONMENTAL MANAGEMENT, Geographic Area, particulate matter, Health Risk Assessment, air toxics, Epidemiology, State, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Biochemistry, Atmospheric Sciences, indoor air, tropospheric ozone, genetic susceptability, Biology, Risk Assessment, ambient air quality, elderly adults, PM10, sulfates, Nitrogen dioxide, sensitive populations, PM 2.5, long term exposure, exposure and effects, stratospheric ozone, acute lung injury, ambient air, exposure, air pollution, lung cancer, Sulfur dioxide, particulate exposure, chronic health effects, sensitive subjects, human exposure, Acute health effects, epidemiological studies, elderly, PM, mortality, tobacco smoke, California (CA), indoor air quality, age dependent response, cumulative effects, respiratory, exposure assessment, genetic susceptibility, environmental hazard exposures, toxicsRelevant Websites:
http://www.llu.edu/llu/health/ahsmog.htmProgress 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.