Particulate Exposure and Cardiovascular Disease in the HPFS

描述（由申请人提供）：与急性空气污染暴露相关的不良影响已得到充分研究;然而，关于慢性暴露影响的证据主要限于少数长期暴露于空气污染的开创性研究。这些研究发现，长期接触颗粒物会增加死亡风险。最近的一些研究拓宽了这一领域的知识，证明了不良健康结果与慢性颗粒物暴露之间的关联，即使在美国许多地区，颗粒物水平随着时间的推移有所下降。我们目前正在进行一项研究，数据来自护士健康研究（NHS），结合改善暴露，协变量和结果评估。与其他研究相比，一个复杂的GIS建模过程估计了每个参与者多年来每个地址的颗粒暴露。此外，我们正在使用每两年更新一次的信息对潜在风险因素进行调整。结果表明，直径小于10微米的慢性颗粒物（PM10）暴露与全因死亡率和致命性心肌梗死显著相关。以前的研究表明，男性和女性接触空气污染的影响存在差异;因此，对男性长期接触空气污染的研究将对文献做出重大贡献。我们建议应用暴露建模方法，已开发的NHS检查在HPFS的慢性颗粒物暴露与全因死亡率和心血管疾病的关系。公共卫生相关性：评估慢性颗粒物暴露与全因死亡率和心血管疾病的关系具有重大的公共卫生意义。这项研究将通过检查男性队列中的这些关联来补充现有文献，因为最近的慢性暴露队列研究主要集中在女性身上。此外，本研究将利用为既往研究开发的暴露模型，并在整个随访期间使用更新的协变量信息。

DESCRIPTION (provided by applicant): Adverse effects associated with acute air pollution exposures have been well studied; however evidence on effects of chronic exposure has mainly been limited to a few seminal studies of long-term exposure to air pollution. These studies found an increased risk of mortality associated with long-term exposure to particulates. A few recent studies have broadened knowledge in this area, demonstrating an association between adverse health outcomes and chronic particulate exposure, even as particulate levels have decreased somewhat over time in many areas of the US. We are currently conducting one of these studies with data from the Nurses' Health Study (NHS), combining improved exposure, covariate and outcome assessment. In contrast to other studies, a complex GIS modeling process estimates particulate exposure for each address for each participant over a number of years. In addition, we are adjusting for potential risk factors using information that is updated every two years. Results indicate significant associations of chronic particulate matter less than 10 microns in diameter (PM10) exposure with all-cause mortality and fatal myocardial infarctions. Previous studies have indicated differences in the effects of air pollution exposure among men and women; therefore a study of chronic exposure among men would contribute significantly to the literature. We propose to apply the exposure modeling methods which have been developed for the NHS to examine in the HPFS the relationships of chronic particulate exposure with all-cause mortality and cardiovascular disease. PUBLIC HEALTH RELEVANCE: Assessing the relationship of chronic particulate exposures to all cause mortality and cardiovascular disease is of great public health significance. This study will add to the current literature by examining these associations among a cohort of men, as recent cohort studies of chronic exposures have focused on women. In addition, the study will take advantage of exposure models that were developed for a previous study and the use of updated covariate information for the entire period of follow-up.