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

摘要 本应用程序是对PAR-19-250标准的响应：《环境对衰老的影响：极端环境的影响》 天气和灾害事件对老龄化人口的影响。空气污染物对老龄化特别有害 人口；暴露于空气污染，以环境颗粒物(例如PM2.5)衡量，与 到随年龄增长的疾病，包括心血管疾病(CVD)和中风。老年妇女(谁 比男性多3：2)特别容易患心血管疾病终点，尤其是中风风险； 女性在绝经后立即加倍。极端天气事件，如野火和长时间 仅在过去十年里，干旱就对加州等州的空气污染暴露产生了不利影响。一个 该州许多大城市县的颗粒物污染水平超过了联邦和州环境 在极端天气事件期间，这些水平与世界上最糟糕的城市不相上下。我们的 总体研究目标是评估极端天气事件和空气污染在 老年女性人群患心血管疾病的风险增加，特别是在易患心血管病的高峰期 卒中。在Aim1中，我们将通过确定以下范围内的中风事件来评估野火事件的急性影响 基于卫星图像的地理上受影响的地区。PM2.5暴露估计值上升，原因是 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 死于中风和心血管疾病。在目标2中，我们将确定特定的PM2.5成分在中风风险和 死亡率。采用基于卫星和基于源的互补方法，我们将确定 可归因于中风的PM2.5及其化学成分。利用25年的跟踪调查 研究人口，这一目标将使我们能够描绘干旱和野火造成的空气污染的成分 事件与其他(例如，交通、工业)暴露。对于这两个目标，选择CVD端点(例如， 还将探讨心肌梗死)。在目标3中，我们将评估PM2.5暴露与 在2000名暴露反映暴露横截面的参与者中进行血清免疫标志物检测 在2015年干旱和野火季节。这一目的将为中风提供所谓的生物基础。 和心血管疾病风险，按PM2.5的关键来源和构成列出。为了成功实现这些目标，我们将利用 加州教师研究的纵向数据，这是一项基于地理定义的基于人群的队列研究 在133,479名妇女中，她们进行了25年的随访：(A)妇女中风和心血管疾病易感性的关键时期， 和(B)加州的空气污染暴露水平升高，那里已经有很长一段时间 干旱和无数的野火。

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.