Grantee Research Project Results
2001 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, 2001 through February 28, 2002
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 fine particulate matter (PM2.5) on all-cause mortality and non-malignant respiratory mortality. The results also will determine lung cancer and cardiovascular disease incidence and mortality. The study will use data from a group of 6,338 nonsmoking California Seventh-Day Adventists, which has 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 multi-pollutant analysis; and (4) evaluate the health effects of air pollutants in sensitive subgroups.
Progress Summary:
The focus of the second year was to complete the update of exposure and outcome information from all participants. The attempt was to complete follow-up on all persons of the Adventist Health and Smog Study (AHSMOG) group who were alive at the last full follow-up in 1992. Of these, some were known dead, and thus a total of 4,103 questionnaires were sent out. As of May 11, 2001, the tracing of those alive was completed with a response rate of 87 percent. Because of the advanced age of the group used, this response rate is considered extremely favorable.
Mortality has been assessed by computerized record linkage with the National Death Index, the California Death Certificate files, and by obtaining death certificates from those identified as part of the AHSMOG group. All relevant death certificates have been requested, and a total of 1,014 deaths have been confirmed.
Surrogate interviews have been completed with a close friend or relative of those who are deceased with a response rate of 76 percent of all known dead (770 of 1,014).
Methods used for tracing have been the following: (1) phone calls to last known address; (2) phone calls to person identified by the participant as always knowing their whereabouts; (3) record linkage with the California Department of Motor Vehicle (DMV); (4) mailing list for church paper; and (5) church clerks.
There are several methods that were used for assessing deaths: (1) information from spouse, close friend, church clerk, postal returns, etc.; (2) computerized record linkage with the California Death Certificate files; (3) computerized record linkage with National Death Index; and (4) obtaining death certificates from the state in which the person died.
Both visibility data and directly monitored data have been received from the State of California. We have calculated the individual exposure measures using the same methodology as before.
Sonoma Technologies has processed the information collected by the California Air Resources Board (CARB) and has provided us with monthly ambient levels of air pollutants (PM10, O3, SO2, NO2, SO4) by zip code through March 2000. Since 1992, several air monitoring stations have been discontinued, and others have been started. This has created some challenges in the development of new algorithms for assessing zip code specific ambient air pollution levels. We have performed quality checks with data from Sonoma Technologies to ensure the new algorithms produce comparable ambient air pollutant levels as previous algorithms by comparing 3 overlapping years (1990-1992). For most pollutants, the consistency was favorable. However, we have found some minor differences for PM10, and we are still resolving these. When we are confident that the two algorithms are comparable for PM10, we will link the new zip code ambient air pollution levels to the individuals in our group for assessing individual exposure to ambient air pollutants. All death certificates have been coded by a certified nosologist and all mortality outcomes have been updated. We currently are using these in our analyses.
Assessment of incident cancer currently is being done by computerized record linkage with the California Cancer Registry. For those living out-of-state, medical histories are being collected from the hospital given by the participant as the place of diagnosis of his/her cancer. This is expected to be completed by September 2002. Validation of self-reported myocardial infarction is being done by obtaining medical records of the hospitals identified by the subject. This is done concurrently with the assessment of incident cancers.
Because the group had not been contacted since 1993, the process was more challenging than expected and it has taken more time than anticipated. However, we are now in the process of completing the analyses relating PM2.5 to mortality outcomes, both in the whole group and in sensitive subgroups. When the comparability of the new algorithm and the old are completed, we will develop zip code specific ambient air pollution levels and start analyses using the other air pollutants as exposure variables.
Future Activities:
The final year will consist of updating cancer incidence through computerized record linkage with the California Cancer Registry and obtaining medical history charts for out-of-state cases. We also will complete validation of self-reported incident myocardial infarctions. Furthermore, we will perform analysis of risk of defined outcomes in relation to the ambient air pollutant levels of the individual subjects. We will focus on the following endpoints: all cause mortality, non-malignant respiratory mortality, and lung cancer and cardiovascular incidence and mortality. These analyses should result in the first abstracts and submitted publications by fall 2002.
In addition, 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 multi-pollutant models. We anticipate several publications resulting from this work. Due to the amount of time needed for collecting the data, we will most likely request a no-cost extension.
Supplemental 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.
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.htm Exit
Progress 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.