Extreme weather, air pollution, and stroke among an aging female population

摘要 本申请是对PAR-19-250：“环境对衰老的影响：极端环境的影响”的回应。 气候和灾害事件对老龄化人口的影响。”空气污染物对衰老尤其有害 人口;暴露于空气污染，通过环境颗粒物测量（例如，PM2.5）已被 随着年龄的增长而增加的疾病，包括心血管疾病（CVD）和中风。老年妇女（ 人数超过男性3：2）特别容易发生CVD终点，特别是卒中风险; 女性在绝经后会立即翻倍。极端天气事件，如野火和长期 仅过去十年的干旱就对诸如加州等州的空气污染暴露产生了不利影响。一 该州许多大都市县的颗粒物污染水平高于联邦和州环境水平 在极端天气事件期间，这些水平与世界上最糟糕的城市相媲美。我们 总体研究目标是评估极端天气事件和空气污染的交叉点， 老年女性人群心血管疾病的风险增加，特别是在高峰易感性， 中风在目标1中，我们将评估野火事件的急性影响， 根据卫星图像确定受影响的地理区域。PM2.5暴露估计值升高是由于 受影响地区的野火事件将与住院治疗（包括急诊室就诊）有关 中风和心血管疾病在目标2中，我们将确定特定PM2.5成分在中风风险中的作用， mortality.利用互补的卫星和源基方法，我们将确定 PM2.5及其化学成分可归因于中风。利用25年的随访， 研究人口，这一目标将使我们能够描绘出干旱和野火造成的空气污染的组成部分 事件相对于其它事件（例如，运输、工业）暴露。对于这两个目标，选择CVD终点（例如， 心肌梗塞）也将被探索。在目标3中，我们将评估PM2.5暴露与 2000名参与者的血清免疫标志物，这些参与者的暴露反映了暴露的横截面 在2015年的干旱和野火季节。这一目标将为中风的生物学基础提供信息 和心血管疾病的风险，主要PM2.5来源和成分。为了成功实现这些目标，我们将利用 来自加州教师研究的纵向数据，这是一项基于地理定义的人群队列研究 在133,479名妇女中，25年的随访跨越：（a）妇女中风和CVD易感性的关键时期， 和（B）加州空气污染暴露水平升高，其中存在长时间的 干旱和许多野火。

ABSTRACT This application is in response to the PAR-19-250: “EnvironmentalInfluences on Aging: Effects of Extreme Weatherand Disaster Events on Aging Populations .”Air pollutants are especially detrimental for aging populations; exposure to air pollution as measured by ambient particulate matter (e.g., PM2.5) has been linked to diseases that increase with age, including cardiovascular diseases (CVD) and stroke. Older women (who outnumber men 3:2) are particularly susceptible to CVD endpoints and to stroke risk in particular; stroke risk in women doubles immediately following menopause. Extreme weather events such as wildfires and prolonged drought in the last decade alone have adversely affected air pollution exposure in states such as California. A number of metropolitan counties in the state have particulate pollution levels above federal and state ambient standards, and during extreme weather events, these levels rival that of the worst cities in the world. Our overall study objective is to evaluate the intersection of extreme weather events and air pollution in an aging female population who are at increased risk for CVDs, and in particular, at peak susceptibility for stroke. In Aim1, we will evaluate the acute effects from wildfire events by ascertaining stroke events within geographically affected areas based on satellite imagery. Elevated PM2.5 exposure estimates resulting from a wildfire event in the affected areas will be associated with hospitalizations (including emergency room visits) from stroke and CVD. In Aim 2, we will determine the role of specific PM2.5 components in stroke risk and mortality. Employing complementary satellite- and source-based approaches, we will identify key sources of PM2.5 and its chemical constituents that are attributable to stroke. Leveraging 25-years of follow-up from the study population, this aim will permit us to delineate components of air pollution from drought and wildfire events versus other (e.g., transportation, industrial) exposures. For both aims, select CVD endpoints (e.g., myocardial infarction) will also be explored. In Aim 3, we will evaluate the association between PM2.5 exposure with serum immune markers among 2000 participants whose exposures reflect a cross-section of exposure during the 2015 drought and wildfire season. This aim will inform the purported biologic underpinning for stroke and CVD risk, by key PM2.5 sources and constituents. To successfully accomplish these aims, we will leverage longitudinal data from the California Teachers Study, a geographically-defined population-based cohort study of 133,479 women whose 25 year follow-up spans: (a) key periods of stroke and CVD susceptibility in women, and (b) elevated levels of air pollution exposure in California where there have been prolonged periods of drought and numerous wildfires.