Cardiovascular Health and Air Pollution: A National Study

心血管健康与空气污染：一项全国研究

• 批准号: 9230837
• 负责人: Antonella Zanobetti
• 金额: $ 53.37万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9230837
• 关键词: Acute; Address; Admission activity; Aerosols; Air; Air Pollution; Algorithms; Big Data; Cardiovascular system; Cells; Cessation of life; Characteristics; Chemicals; Chronic; Code; Communities; Computer software; Data; Data Set; Elderly; Enrollment; Exposure to; Future; Gases; Goals; Health; Health Benefit; Heart; Heat Waves; Heterogeneity; Individual; Intervention; Investigation; Joints; Knowledge; Link; Location; Maps; Measurement; Measures; Medicare; Meteorology; Methodology; Methods; Modeling; Modification; Monitor; Myocardial Infarction; New England; Older Population; Optics; Outcome; Output; Ozone; Particulate Matter; Pollution; Population; Public Health; Research; Resolution; Risk; Rural; Rural Population; Sample Size; Sampling; Shapes; Source; Statistical Methods; Stroke; Surface; Surveys; Temperature; United States Environmental Protection Agency; World Health Organization; air quality regulation; analytical method; base; beneficiary; cardiovascular disorder risk; cardiovascular health; climate change; cohort; cost; cost effective; disorder risk; epidemiology study; evidence base; experience; extreme heat; fine particles; improved; innovation; land use; pollutant; premature; programs; public health relevance; response; rural area; socioeconomics; spatiotemporal; study population; synergism; temporal measurement; urban area

 DESCRIPTION (provided by applicant): Short and long-term exposures to fine particulate matter (PM2.5) have been associated with increased risks of cardiovascular disease in large urban areas. Although previous studies have included increasingly larger populations and sophisticated analytical methods, many gaps of knowledge remain. One limitation is that by relying on the Environmental Protection Agency air pollution monitoring network only studies will: 1) exclude less urban areas where PM2.5 is not monitored; 2) not be able to differentiate health effects associated with regional/ long-range transport versus local pollution sources; and 3) not be able to estimate health effects of air pollution at low concentrations, which requires large populations in that exposure range. In addition, with the mounting threat of climate change, evidence regarding a potential synergistic effect of air pollution and heat is totally lacking. In Aim 1 we will integrate satellite-based aerosol optical depth (AOD) data with land use regression variables to predict and validate daily PM2.5 levels at 1x1 km grid cell resolution for the entire US. This data will be used to calculate zip-code exposures that vary by location and date, which will be linked to the entire Medicare cohort (90% of the US elderly population) over the period 2000 to 2013. In Aim 2 we will develop computationally efficient algorithms to analyze these linked data sets and provide evidence of acute and chronic risks of cardiovascular disease of unprecedented accuracy by using improved exposure to PM2.5 at a very local scale, and including rural populations from locations in which pollution monitors are not available. We will estimate the shape of the exposure-response relationship between cardiovascular admissions and PM2.5 to address questions of effects below the air quality standards; and evaluate effect modification by rural/ urban area, by multiple socioeconomic measures, by individual and by land use characteristics. In Aim 2.1 we will decompose the estimated daily pollution surfaces into different spatial scales, representing regional/long- range transport and locally-generated pollution. In Aim A.2.2 we will estimate the effects of PM2.5 components and gases in urban and rural areas in New England. In Aim A.2.2 we will develop approaches to adjust for confounding bias using auxiliary information. In Aim 3 we will estimate the acute and chronic health risks associated with simultaneous exposure to heat and PM2.5. In Aim 4, we will make available to the research community maps of the output obtained in the previous aims. We will also disseminate software for the efficient implementation of the newly developed statistical methods needed for the analysis of these big data sets. In summary, without a substantial improvement in the accuracy of the exposure data, sample size, methodology, and characterization of the exposure response relationship and the joint effects of heat and air pollution, it will be challenging to provide the necessary evidence for future air quality regulations. The results will provide a much needed evidence base for developing the most cost effective and beneficial air quality interventions.

 描述（由申请人提供）：短期和长期接触细颗粒物 (PM2.5) 与大城市地区心血管疾病风险增加有关。尽管之前的研究涵盖了越来越多的人群和复杂的分析方法，但仍然存在许多知识空白。一个限制是，依赖于环境保护局空气污染监测网络的研究只能：1）排除较少未监测PM2.5的城市地区； 2) 无法区分与区域/远程运输和当地污染源相关的健康影响； 3）无法估计低浓度空气污染对健康的影响，这需要大量人口处于该暴露范围内。此外，随着气候变化的威胁日益严重，完全缺乏关于空气污染和高温潜在协同效应的证据。在目标 1 中，我们将基于卫星的气溶胶光学深度 (AOD) 数据与土地利用回归变量相结合，以 1x1 km 网格单元分辨率预测和验证整个美国的每日 PM2.5 水平。该数据将用于计算因地点和日期而异的邮政编码暴露，并将其与 2000 年至 2013 年期间的整个医疗保险队列（占美国老年人口的 90%）相关联。在目标 2 中，我们将开发计算高效的算法来分析这些关联的数据集，并通过使用改进的 PM2.5 暴露，以前所未有的准确性提供急性和慢性心血管疾病风险的证据。 在非常局部的范围内，包括来自没有污染监测器的地区的农村人口。我们将估计心血管入院与 PM2.5 之间的暴露-反应关系的形状，以解决低于空气质量标准的影响问题；评估农村/城市地区、多种社会经济措施、个人和土地利用特征的影响修改。在目标 2.1 中，我们将估计的每日污染面分解为不同的空间尺度，代表区域/远程传输和当地产生的污染。在目标 A.2.2 中，我们将估计 PM2.5 成分和气体对新英格兰城市和农村地区的影响。在目标 A.2.2 中，我们将开发使用辅助信息来调整混杂偏差的方法。在目标 3 中，我们将估计与同时暴露于高温和 PM2.5 相关的急性和慢性健康风险。在目标 4 中，我们将向研究界提供之前目标中获得的输出图。我们还将传播软件，以有效实施分析这些大数据集所需的新开发的统计方法。综上所述，如果暴露数据的准确性、样本量、方法、暴露响应关系以及热和空气污染的共同影响的表征没有实质性改善，为未来的空气质量监管提供必要的证据将是一项挑战。研究结果将为制定最具成本效益和有益的空气质量干预措施提供急需的证据基础。