Particulate air pollution and effects on cardiovascular health in American Indian communities

项目摘要/摘要 空气污染是心血管健康的一个关键环境决定因素，但大多数研究都是 在以白人为主的非农村人口中进行。解释这种暴露-反应关系的证据-- 这艘船仅限于主要位于空气污染水平较高地区的美国印第安人部落社区 低于现行的国家环境空气质量标准(NAAQS)。为了解决这一研究差距，我们打算 比较美国印第安人社区与其他地区环境中细颗粒物(PM2.5)的浓度 美国和估计PM2.5与心血管疾病(CVD)之间的关系 在位于大平原北部(北达科他州/南达科他州)、大平原南部(俄克拉荷马州- 和美国西南航空(亚利桑那州)，利用来自NHLBI资助的强心脏研究(SHS)的数据。 一群人。我们将：1)估计对PM2.5总质量贡献最大的六种PM2.5组分的浓度 (硫酸盐、硝酸盐、铵、有机物、炭黑和粉尘)在人工智能居多的县随时间推移 与使用现有验证良好、空间分辨率高的卫星模型的美国其他县相比；2) 评估长期暴露于a)总PM2.5和b)6种PM2.5成分与事件心血管疾病的关系， 分别测量PM2.5暴露对任何事件CVD和特定CVD结果的影响(冠状动脉 心脏病(CHD)、心力衰竭、中风)；3)评估总的 PM2.5暴露对自闭症患者糖尿病心血管事件的影响及探索性分析 代谢综合征修饰(METS)，在SHS参与者中被诊断为至少符合以下五种疾病中的三种： 疾病：(1)高腰围，(2)高甘油三酯水平，(3)低高密度脂蛋白，(4)高血压， (5)空腹血糖升高。 估计美国各地人工智能社区的环境PM2.5趋势，并量化PM2.5(不包括 在SHS中对事件心血管疾病风险的定位效应将有助于促进对环境健康负担的理解 在社会弱势群体中所面临的挑战。我们的发现可以用来促进循证预防 以及从地方到国家的各种规模的干预。这项工作可以帮助以社区为基础的干预- 人工智能社区内降低PM2.5水平并改善心血管健康结果和优先事项的行动- 在NAAQS的未来迭代中实现公平代表制。

PROJECT SUMMARY/ABSTRACT Air pollution is a key environmental determinant of cardiovascular health, yet most studies have been conducted in predominantly white, non-rural populations. Evidence elucidating this exposure-response relation- ship is limited for rural, American Indian tribal communities primarily located in regions with air pollution levels below the current National Ambient Air Quality Standards (NAAQS). To address this research gap, we intend to compare ambient fine particulate matter (PM2.5) concentrations in American Indian communities to the rest of the United States (US) and estimate the associations between PM2.5 and incident cardiovascular disease (CVD) in tribal communities located in the Northern Great Plains (North/South Dakota), Southern Great Plains (Okla- homa), and American Southwest (Arizona), leveraging data from the NHLBI-funded Strong Heart Study (SHS) cohort. We will: 1) estimate concentrations of the six PM2.5 constituents contributing the most to total PM2.5 mass (sulfate, nitrate, ammonium, organic matter, black carbon, and dust) over time in largely AI-populated counties compared to other US counties using existing well-validated, highly spatially resolved satellite-based models; 2) evaluate the association of long-term exposure to a) total PM2.5 and b) six PM2.5 constituents with incident CVD, measuring the effect of PM2.5 exposure on any incident CVD and specific CVD outcomes separately (coronary heart disease (CHD), heart failure, stroke); 3) assess effect modification of the association between total PM2.5 exposure on incident CVD by diabetes status in the SHS and conduct an exploratory analysis of effect modification by metabolic syndrome (MetS), diagnosed in SHS participants who meet at least three of five con- ditions: (1) high waist circumference, (2) high triglyceride level, (3) low HDL cholesterol, (4) high blood pressure, and (5) high fasting blood glucose. Estimating ambient PM2.5 trends in AI communities across the contiguous US and quantifying PM2.5 ex- posure effects on incident CVD risk in the SHS will help advance understanding of environmental health burdens faced in socially disadvantaged communities. Our findings can be used to promote evidence-based prevention and intervention at various scales, from local to national. This work can help inform community-based interven- tions within AI communities to decrease PM2.5 levels and improve cardiovascular health outcomes and prioriti- zation of equitable representation in future iterations of NAAQS.