Cardiovascular health and exposure to PM2.5 constituents: a multi-cohort study

心血管健康与 PM2.5 成分暴露：多队列研究

• 批准号: 10263210
• 负责人: Fengchao Liang
• 金额: $ 54.72万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263210
• 关键词: Acute myocardial infarction; Adult; Affect; Air; Caliber; Carbon; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cessation of life; Chemicals; China; Chinese People; Cities; Cohort Analysis; Cohort Studies; Communities; Concentration measurement; Cox Proportional Hazards Models; Custom; Data; Data Set; Disease Outcome; Europe; Event; Exposure to; Health; Heart failure; Heavy Metals; Hospitals; Household; Incidence; Individual; Indoor Air Pollution; Industrialization; Intervention; Investigation; Investments; Joints; Knowledge; Lead; Long-Term Effects; Machine Learning; Measurement; Measures; Meteorology; Modeling; Morbidity - disease rate; Nickel; Nitrates; North America; Outcome; Participant; Particulate Matter; Personal Health Records; Policies; Pollution; Predisposition; Public Health; Recording of previous events; Records; Research; Resolution; Shapes; Stroke; Sulfate; Supercomputing; Tennessee; Time; Toxic effect; Training; Universities; Urbanization; Variant; Work; adjudicate; ambient air pollution; base; burden of illness; cardiovascular disorder risk; cardiovascular health; cohort; design; effective intervention; fine particles; follow-up; insight; land use; models and simulation; mortality; particle; response; study population; years of life lost

Project Summary Cardiovascular diseases (CVD) are the primary cause of death and a major cause of years of life lost in the US and in the world. Cohort studies conducted in North America and Europe have provided crucial information in identifying exposure to ambient fine particulate matter (PM2.5) as a cause of increased CVD risks. They have also pointed out important directions for future research, including the differential toxicity of PM2.5 chemical constituents to CVD incidence, the shape of concentration-response (C-R) functions, impact of exposure time windows and indoor air pollution exposure. The objectives of our study are to assess the associations between long-term exposure to PM2.5 constituents and incident CVD, and investigate the impact of exposure time window and indoor air pollution on these associations. Approach. We will conduct a retrospective multi-cohort study in China using personal health records from five national cohorts with adjudicated CVD endpoints maintained by the Fuwai Hospital. To provide individual-level exposure trajectories for ~120,000 cohort participants during their follow-up period, we will develop an ensemble machine learning model using ground air quality measurements, satellite data, and air quality model simulations to generate 1 km resolution national PM2.5 mass and major constituent (sulfates, nitrates, elemental carbon, organic carbon, lead, and nickel) exposure estimates between 1998 and 2020 (Aim 1). Using cohort data from 2007 to 2020 for our main analyses, we will use Cox proportional hazard models to estimate the associations of long-term exposures to PM2.5 constituents and adverse cardiovascular outcomes including total CVD, acute myocardial infarction, and stroke (Aim 2). Variations of this model will be used to investigate the shape of the C-R functions (linear vs. non-linear) as well as the impact of exposure errors using exposure estimates between 1998 and 2020 (Aim 2a). We will also examine windows of susceptibility for CVD endpoints using both time-variant and time- invariant exposure metrics (Aim 2b). Finally, we will evaluate the confounding effect of indoor air pollution on the C-R functions using a sub-cohort with estimated personal PM2.5 exposure estimates based on Fuwai Hospital's ongoing Multi-Region Panel Study (Aim 2c). Expected Results. Given the tremendous variability in PM2.5 constituent concentrations in China over time and space, our findings will contribute new PM2.5 constituent-specific C-R functions in CVD burden calculation in both the US and the world. Our study will also expand our knowledge on important factors affecting these associations such as exposure window and indoor air pollution.

项目摘要 心血管疾病(CVD)是美国人死亡的主要原因，也是导致寿命损失的主要原因 在这个世界上。在北美和欧洲进行的队列研究提供了关键信息 确定暴露于环境中的细颗粒物(PM2.5)是心血管疾病风险增加的原因。他们有 还指出了未来研究的重要方向，包括PM2.5化学物质的不同毒性 心血管疾病发病率的构成因素、浓度-反应(C-R)函数的形状、暴露时间的影响 窗户和室内空气污染暴露。我们研究的目的是评估两者之间的联系 长期暴露于PM2.5组分和事件心血管疾病，并调查暴露时间的影响 窗户和室内空气污染对这些协会的影响。接近。我们将进行一项回溯性多队列研究 利用5个已判定心血管疾病终点的全国队列人群的个人健康档案对中国的研究 由阜外医院维持。为大约120,000个队列提供个人级别的暴露轨迹 在参与者的后续阶段，我们将开发一个使用GROUND的集成机器学习模型 空气质量测量、卫星数据和空气质量模式模拟，以生成1公里分辨率的国家 PM2.5质量和主要成分(硫酸盐、硝酸盐、元素碳、有机碳、铅和镍) 1998年至2020年期间的暴露估计数(目标1)。使用2007到2020年的队列数据为我们的主要 分析，我们将使用COX比例风险模型来估计长期暴露于 PM2.5成分和不良心血管后果，包括总心血管疾病、急性心肌梗死和 笔划(目标2)。这个模型的变化将被用来研究C-R函数的形状(线性与 非线性)以及使用1998至2020年间曝光估计数的曝光误差的影响(目标 2a)。我们还将使用时变和时间来检查CVD终端的易感窗口。 不变暴露指标(目标2b)。最后，我们将评估室内空气污染对 C-R使用基于阜外的估计个人PM2.5暴露估计的子队列来发挥作用 医院正在进行的多区域小组研究(AIM 2c)。预期结果。由于存在巨大的多样性， 中国的PM2.5组分浓度随时间和空间的变化，我们的发现将贡献新的PM2.5 在美国和世界上，特定成分的C-R在心血管疾病负担计算中发挥作用。我们的研究也将 扩大我们对影响这些关联的重要因素的了解，例如曝光窗和室内 由于空气污染。