Climate Penalty: Climate-driven Increases in Ozone and PM2.5 Levels and Mortality

项目摘要 气候变化是21世纪世纪最大的公共卫生挑战。虽然许多途径的 气候变化对健康的影响，“气候惩罚”效应，即，变暖的气温 对环境空气质量及其对人体健康的影响仍然知之甚少， 与全球变暖有关的被低估的公共卫生负担。我们之前的流行病学研究 据报道，较高的夏季平均温度和较高的PM2.5浓度分别与以下因素有关： 美国东南部（SEUS）医疗保险人群（年龄≥65岁）的全因死亡率增加1，2。卫星 和地面观测表明，空气污染的年际变化有很强的依赖性 SEUS 3夏季平均气温。这些研究结果表明，温度的间接健康影响， 在SEUS地区，气候对空气质量的惩罚可能是潜在的重要因素，除了直接的不利影响外， 我们观察到的影响。然而，明确的流行病学证据表明，空气污染是一种媒介， 温度对健康的影响，目前的文献中仍然缺少对这种影响的准确估计。在此， 根据我们的初步结果，我们假设温度升高可以间接影响全因死亡率， 通过恶化SEUS中的PM2.5和臭氧水平。我们提出了一项研究，将利用医疗保险 2000-2016年的队列（1.24亿人-年），SEUS和 高分辨率的温度、PM2.5和O3数据，以调查响应“气候”的全因死亡率 惩罚”效果的中介统计分析。具体来说，在这个项目中，我们将（1）更新现有的- 2016年SEUS 1平方公里网格的日温度和臭氧预测， 机器学习模型的平均值;（2）量化“气候惩罚”对全因死亡率的健康影响 使用中介分析，并探讨减少人为空气污染排放是否可以作为 （3）对与气候变化相关的超额死亡进行风险评估， 使用气候模式输出的2050年中期和世纪后期（2100年）空气污染的气候惩罚， 化学传输模型，沿着自上而下的估计“气候惩罚”的目标2。拟议 研究将提高对气候、空气污染和人类健康之间相互作用的理解， 真实世界的大数据，并提供流行病学证据的一个重要途径， 影响人类健康，与气候和环境决策直接相关。

Project Summary Climate change is the greatest public health challenge of the 21st century. While numerous pathways of the health impact of climate change have been proposed, the “climate penalty” effect, i.e., a warming temperature worsens ambient air quality and consequently influences human health, remains poorly understood, resulting in an underestimated public health burden associated with global warming. Our previous epidemiological studies have reported that higher summer mean temperatures and higher PM2.5 concentrations are each associated with increased all-cause mortality in the Medicare population (aged ≥65) in the Southeastern US (SEUS)1, 2. Satellite and ground-based observations suggest a strong dependence of air pollution on interannual variabilities of summer mean temperature in SEUS3. These findings suggest that the indirect health effect of temperature via the climate penalty on air quality can be potentially important in the SEUS region, in addition to the direct adverse effects that we observed. However, clear epidemiological evidence of the air pollution serving as a mediator for the health effects of temperature, and accurate estimate of this effect is still missing in current literature. Herein, drawing on our preliminary results, we hypothesize that rising temperature can indirectly affect all-cause mortality via worsening both PM2.5 and ozone levels in the SEUS. We propose a study that will leverage the Medicare cohort from 2000-2016 (124 million person-years), the largest longitudinal cohort available for the SEUS and the high-resolution temperature, PM2.5, and O3 data, to investigate all-cause mortality in response to the “climate penalty” effect using a mediation statistical analysis. Specifically, in this project we will (1) update the present- day temperature and ozone predictions at 1-km2 grids across the SEUS through 2016 by incorporating ensemble averaging of machine learning models; (2) quantify the health effect of “climate penalty” on all-cause mortality using a mediation analysis, and explore whether mitigating anthropogenic air pollution emissions might serve as a pathway of climate change adaptation; (3) perform a risk assessment on the excess deaths related to the climate penalty on air pollution for the mid- (2050) and late-21st century (2100), using climate model output, chemical transport modeling, along with the top-down estimate of “climate penalty” from Aim 2. The proposed research will improve understanding of the interplays between climate, air pollution, and human health based on real-world big data, and provide epidemiological evidence of an important pathway that climate change adversely affects human health, with immediate relevance to climate and environmental policymaking.