Impact of Climate Change on Life Expectancy in a Multiethnic Population

摘要 气候变化是一个日益增长的公共卫生优先事项，因为极端高温，野火和其他自然灾害 导致发病率和死亡率的急性影响;然而，极端高温和野火的长期后果 很少被研究。这部分是由于缺乏纵向信息的研究， 个人和邻里水平的因素和精细尺度的气候和野火数据。迫切需要 在精心设计的研究中调查极端高温和野火的长期后果，包括 全面评估这些照射及其对预期寿命的独立和联合影响， 再加上对可能的中介因素（空气污染）和调节因素（社会经济地位， 人口统计学、合并症、健康行为、邻里环境和地理）。此外，委员会认为， 人们对气候变化影响死亡率的生物过程还不甚了解。虽然有证据表明 空气污染对DNA甲基化作为表观遗传调节的一种衡量标准的影响正在积累， 和DNA甲基化的影响很小。阐明潜在途径并鉴定 需要对高危人群进行干预。为了弥补这些差距，我们将进行严格的 调查极端高温和野火烟雾对成年人预期寿命的影响， 多种族队列研究的流行病学资源，这是一项基于人群的大型研究，包括 来自加州的112，000名成年男性和女性，1993-1996年入组时年龄为45-75岁，目前 年龄在72-103岁之间，不同种族/民族和社会经济群体的代表性很强。具体来说，我们将 为加州多种族队列参与者生成并表征极端高温和野火烟雾 跨越24年（目标1）;评估长期暴露于极端高温和野火的影响 吸烟对预期寿命影响（目标2）和DNA甲基化与表观遗传年龄（目标3）。这种做法的优点是， 建议包括：1）使用最先进的暴露评估方法来描述极端高温， 野火烟雾，和重要的标准空气污染物; 2）一个大的人口为基础的样本，详细的个人- 和邻域水平的数据和足够的力量来检测适度的影响，广泛推广到 相似的性别，种族/民族和社会经济群体在美国; 3）生物学的作用评估 途径（DNA甲基化），其中极端高温和野火烟雾可能运作;和4）彻底 调查各种因素的影响修改，包括可修改的邻里环境， 以及空气污染的影响。这项提案的结果将扩大我们对以下问题的理解： 长期极端高温和野火烟雾对预期寿命的影响。这些知识 翻译相关性，为决策者和执行科学家提供经验证据， 制定战略干预措施和应对计划，以应对极端高温和野火对健康的影响 抽烟

ABSTRACT Climate change is a growing public health priority as extreme heat, wildfires, and other natural disasters have led to acute effects on morbidity and mortality; yet, the long-term consequences of extreme heat and wildfires have been sparsely studied. This is due in part to the paucity of studies with longitudinal information on individual- and neighborhood-level factors and fine-scale climate and wildfire data. There is an urgent need to investigate the long-term consequences of extreme heat and wildfires in well-designed studies that include a comprehensive assessment of these exposures and their independent and joint effects on life expectancy, coupled with a critical evaluation of possible mediators (air pollution) and moderators (socioeconomic status, demographics, comorbidities, health behaviors, neighborhood environments, and geography). Furthermore, the biological processes by which climate change affects mortality are not well understood. While evidence of the impact of air pollution on DNA methylation as a measure of epigenetic regulation is accumulating, studies of extreme heat and DNA methylation are sparse. Elucidation of the underlying pathways and the identification of interventions for high-risk groups are needed. To address these gaps, we will conduct a rigorous investigation of the impacts of extreme heat and wildfire smoke on adult life expectancy, leveraging the unique epidemiological resources of the Multiethnic Cohort Study, a large population-based study that includes 112,000 adult men and women from California, who were ages 45-75 at enrollment in 1993-1996 and currently ages 72-103 with strong representation of diverse racial/ethnic and socioeconomic groups. Specifically, we will generate and characterize extreme heat and wildfire smoke for California Multiethnic Cohort participants spanning a 24-year period (Aim 1); assess the impacts of long-term exposures of extreme heat and wildfire smoke on life expectancy (Aim 2); and DNA methylation and epigenetic age (Aim 3). The strengths of this proposal include: 1) the use of state-of-the-art exposure assessment methods to characterize extreme heat, wildfire smoke, and important criteria air pollutants; 2) a large population-based sample with detailed individual- and neighborhood-level data and sufficient power to detect modest effects that are broadly generalizable to similar sex, racial/ethnic, and socioeconomic groups in the US; 3) the assessment of the role of biological pathways (DNA methylation) by which extreme heat and wildfire smoke may operate; and 4) a thorough investigation of effect modification by a variety of factors including modifiable neighborhood environments as well as the mediation of effects by air pollution. Findings from this proposal will expand our understanding of the contribution of long-term extreme heat and wildfire smoke on life expectancy. This knowledge has translational relevance in providing empirical evidence for policy makers and implementation scientists to develop strategic interventions and response plans to combat the health effects of extreme heat and wildfire smoke.