Research Hub

Background: Some studies have linked long-term exposure to traffic related air pollutants (TRAP) with adverse cardiovascular health outcomes; however, previous studies have not linked highly variable concentrations of TRAP measured at street-level within neighborhoods to cardiovascular health outcomes. Methods: Long-term pollutant concentrations for nitrogen dioxide [NO2], nitric oxide [NO], and black carbon [BC] were obtained by street-level mobile monitoring on 30 m road segments and linked to residential addresses of 41,869 adults living in Oakland during 2010 to 2015. We fit Cox proportional hazard models to estimate the relationship between air pollution exposures and time to first cardiovascular event. Secondary analyses examined effect modification by diabetes and age. Results: Long-term pollutant concentrations [mean, (standard deviation; SD)] for NO2, NO and BC were 9.9 ppb (SD 3.8), 4.9 ppb (SD 3.8), and 0.36 μg/m3 (0.17) respectively. A one SD increase in NO2, NO and BC, was associated with a change in risk of a cardiovascular event of 3% (95% confidence interval [CI] -6% to 12%), 3% (95% CI -5% to 12%), and - 1% (95% CI -8% to 7%), respectively. Among the elderly (≥65 yrs), we found an increased risk of a cardiovascular event of 12% for NO2 (95% CI: 2%, 24%), 12% for NO (95% CI: 3%, 22%), and 7% for BC (95% CI: -3%, 17%) per one SD increase. We found no effect modification by diabetes. Conclusions: Street-level differences in long-term exposure to TRAP were associated with higher risk of cardiovascular events among the elderly, indicating that within-neighborhood differences in TRAP are important to cardiovascular health. Associations among the general population were consistent with results found in previous studies, though not statistically significant.

Published May 15, 2018

Alexeeff, S. E., Roy, A., Shan, J., Liu, X., Messier, K., Apte, J. S., Portier, C., Sidney, S., & Van Den Eeden, S. K. (2018). High-resolution mapping of traffic related air pollution with Google street view cars and incidence of cardiovascular events within neighborhoods in Oakland, CA. Environmental Health: A Global Access Science Source, 17(1), 1–13. https://doi.org/10.1186/s12940-018-0382-1

This article addresses the problem of “eco-anxiety” by integrating results from numerous fields of inquiry. Although climate change may cause direct psychological and existential impacts, vast numbers of people already experience indirect impacts in the form of depression, socio-ethical paralysis, and loss of well-being. This is not always evident, because people have developed psychological and social defenses in response, including “socially constructed silence.” I argue that this situation causes the need to frame climate change narratives as emphasizing hope in the midst of tragedy. Framing the situation simply as a threat or a possibility does not work. Religious communities and the use of methods which include spirituality have an important role in enabling people to process their deep emotions and existential questions. I draw also from my experiences from Finland in enabling cooperation between natural scientists and theologians in order to address climate issues.

Published May 15, 2018

Pihkala, P. (2018). ECO-ANXIETY, TRAGEDY, AND HOPE: PSYCHOLOGICAL AND SPIRITUAL DIMENSIONS OF CLIMATE CHANGE. Zygon, 53(2), 545–569. https://doi.org/10.1111/zygo.12407

Background
Few studies have explored the relationship between air pollution and fertility. We used a natural experiment in California when coal and oil power plants retired to estimate associations with nearby fertility rates.

Methods
We used a difference-in-differences negative binomial model on the incident rate ratio scale to analyze the change in annual fertility rates among California mothers living within 0-5 km and 5-10 km of 8 retired power plants between 2001 and 2011. The difference-in-differences method isolates the portion of the pre- versus post-retirement contrast in the 0-5 km and 5-10 km bins, respectively, that is due to retirement rather than secular trends. We controlled for secular trends with mothers living 10-20 km away. Adjusted models included fixed effects for power plant, proportion Hispanic, Black, high school educated, and aged > 30 years mothers, and neighborhood poverty and educational attainment.

Results
Analyses included 58,909 live births. In adjusted models, we estimated that after power plant retirement annual fertility rates per 1000 women aged 15–44 years increased by 8 births within 5 km and 2 births within 5-10 km of power plants, corresponding to incident rate ratios of 1.2 (95% CI: 1.1–1.4) and 1.1 (95% CI: 1.0–1.2), respectively. We implemented a negative exposure control by randomly selecting power plants that did not retire and repeating our analysis with those locations using the retirement dates from original 8 power plants. There was no association, suggesting that statewide temporal trends may not account for results.

Conclusions
Fertility rates among nearby populations appeared to increase after coal and oil power plant retirements. Our study design limited the possibility that our findings resulted from temporal trends or changes in population composition. These results require confirmation in other populations, given known methodological limitations of ecologic study designs.

Published May 2, 2018

Casey, J. A., Gemmill, A., Karasek, D., Ogburn, E. L., Goin, D. E., & Morello-Frosch, R. (2018). Increase in fertility following coal and oil power plant retirements in California. Environmental Health 2018 17:1, 17(1), 44-. https://doi.org/10.1186/S12940-018-0388-8

In utero exposure to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) has been linked to child lung function. Overlapping evidence suggests that child sex and exposure timing may modify effects and associations may be mediated through glutathione S-transferase P1 (GSTP1) methylation.

Prenatal PM2.5 exposure in late pregnancy was associated with impaired early childhood lung function and hypermethylation of GSTPI in DNA isolated from nasal epithelial cells. There was a trend towards higher GSTP1 percent methylation being associated with reduced FEV1. All findings were most evident among boys.

Published Apr 27, 2018

Lee, A.G., Le Grand, B., Hsu, HH.L. et al. Prenatal fine particulate exposure associated with reduced childhood lung function and nasal epithelia GSTP1 hypermethylation: Sex-specific effects. Respir Res 19, 76 (2018). https://doi.org/10.1186/s12931-018-0774-3

INTRODUCTION
The United States and Western Europe have seen great
improvements in air quality, presumably in response to
various regulations curtailing emissions from the broad
range of sources that have contributed to local, regional,
and global pollution. Such regulations, and the ensuing
controls, however, have not come without costs, which are
estimated at tens of billions of dollars per year. These costs
motivate accountability-related questions such as, to what
extent do regulations lead to emissions changes? More
important, to what degree have the regulations provided
the expected human health benefits?
Here, the impacts of specific regulations on both electricity generating unit (EGU*) and on-road mobile sources
are examined through the classical accountability process
laid out in the 2003 Health Effects Institute report linking
regulations to emissions to air quality to health effects, with
a focus on the 1999–2013 period. This analysis centers on
regulatory actions in the southeastern United States and
their effects on health outcomes in the 5-county Atlanta
metropolitan area. The regulations examined are largely
driven by the 1990 Clean Air Act Amendments (C). This
work investigates regulatory actions and controls promulgated on EGUs: the Acid Rain Program (ARP), the NOx
Budget Trading Program (NBP), and the Clean Air Interstate Rule (CAIR) — and mobile sources: Tier 2 Gasoline
Vehicle Standards and the 2007 Heavy Duty Diesel Rule

Published Apr 1, 2018

Air pollution has a great impact on health, representing one of the leading causes of death worldwide. Previous experimental and epidemiological studies suggested the role of pollutants as risk factors for cardiovascular diseases. For this reason, international guidelines included specific statements regarding the contribution of particulate matter exposure to increase the risk of these events. In this review, we summarise the main evidence concerning the mechanisms involved in the processes linking air pollutants to the development of cardiovascular diseases.

Published Mar 27, 2018

Vidale, S., & Campana, C. (2018). Ambient air pollution and cardiovascular diseases: From bench to bedside. European Journal of Preventive Cardiology, 25(8), 818–825. https://doi.org/10.1177/2047487318766638

Rationale: Nearly 60% of U.S. children live in counties with particulate matter less than or equal to 2.5 μm in aerodynamic diameter (PM2.5) concentrations above air quality standards. Understanding the relationship between ambient air pollution exposure and health outcomes informs actions to reduce exposure and disease risk.

Objectives: To evaluate the association between ambient PM2.5 levels and healthcare encounters for acute lower respiratory infection (ALRI).

Methods: Using an observational case-crossover design, subjects (n = 146,397) were studied if they had an ALRI diagnosis and resided on Utah’s Wasatch Front. PM2.5 air pollution concentrations were measured using community-based air quality monitors between 1999 and 2016. Odds ratios for ALRI healthcare encounters were calculated after stratification by ages 0–2, 3–17, and 18 or more years.

Measurements and Main Results: Approximately 77% (n = 112,467) of subjects were 0–2 years of age. The odds of ALRI encounter for these young children increased within 1 week of elevated PM2.5 and peaked after 3 weeks with a cumulative 28-day odds ratio of 1.15 per +10 μg/m3 (95% confidence interval, 1.12–1.19). ALRI encounters with diagnosed and laboratory-confirmed respiratory syncytial virus and influenza increased following elevated ambient PM2.5 levels. Similar elevated odds for ALRI were also observed for older children, although the number of events and precision of estimates were much lower.

Conclusions: In this large sample of urban/suburban patients, short-term exposure to elevated PM2.5 air pollution was associated with greater healthcare use for ALRI in young children, older children, and adults. Further exploration is needed of causal interactions between PM2.5 and ALRI.

Keywords: respiratory syncytial virus; influenza virus; bronchiolitis; bronchitis; PM2.5

Published Mar 22, 2018

Horne, B. D., Joy, E. A., Hofmann, M. G., Gesteland, P. H., Cannon, J. B., Lefler, J. S., . . . Pope, C. A. (2018). Short-term elevation of fine particulate matter air pollution and acute lower respiratory infection. American Journal of Respiratory and Critical Care Medicine, 198(6), 759-766. doi:10.1164/rccm.201709-1883oc

The adverse health effects of air pollution have long been recognised; however, there is less awareness that the majority of the morbidity and mortality caused by air pollution is due to its effects on the cardiovascular system. Evidence from epidemiological studies have demonstrated a strong association between air pollution and cardiovascular diseases including stroke. Although the relative risk is small at an individual level, the ubiquitous nature of exposure to air pollution means that the absolute risk at a population level is on a par with “traditional” risk factors for cardiovascular disease. Of particular concern are findings that the strength of this association is stronger in low and middle income countries where air pollution is projected to rise as a result of rapid industrialisation. The underlying biological mechanisms through which air pollutants exert their effect on the vasculature are still an area of intense discussion. A greater understanding of the effect size and mechanisms is necessary to develop effective strategies at individual and policy levels to mitigate the adverse cardiovascular effects of air pollution.

Published Jan 3, 2018

Lee, K. K., Miller, M. R., & Shah, A. S. V. (2018). Air pollution and stroke. Journal of Stroke, 20(1), 2–11. https://doi.org/10.5853/jos.2017.02894

Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.

Published Jan 1, 2018

Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Basu, N. (Nil), Baldé, A. B., Bertollini, R., Bose-O’Reilly, S., Boufford, J. I., Breysse, P. N., Chiles, T., Mahidol, C., Coll-Seck, A. M., Cropper, M. L., Fobil, J., Fuster, V., Greenstone, M., Haines, A., … Zhong, M. (2018). The Lancet Commission on pollution and health. The Lancet, 391(10119), 462–512. https://doi.org/10.1016/S0140-6736(17)32345-0

Elevated levels of fine particulate matter,2.5 mm in aerodynamic diameter (PM2.5) are associated with increased risk of cardiovascular outcomes and death, but their association with risk of CKD and ESRD is unknown. We linked the Environmental Protection Agency and the Department of Veterans Affairs databases to build an observational cohort of 2,482,737 United States veterans, and used survival models to evaluate the association of PM2.5 concentrations and risk of incident eGFR,60 ml/min per 1.73 m2, incident CKD, eGFR decline $30%, and ESRD over a median follow-up of 8.52 years. County-level exposure was defined at baseline as the annual average PM2.5 concentrations in 2004, and separately as time-varying where it was updated annually and as cohort participants moved. In analyses of baseline exposure (median, 11.8 [interquartile range, 10.1–13.7] mg/m3), a 10-mg/m3 increase in PM2.5 concentration was associated with increased risk of eGFR,60 ml/min per 1.73 m2 (hazard ratio [HR], 1.21; 95% confidence interval [95% CI], 1.14 to 1.29), CKD (HR, 1.27; 95% CI, 1.17 to 1.38), eGFR decline $30% (HR, 1.28; 95% CI, 1.18 to 1.39), and ESRD (HR, 1.26; 95% CI, 1.17 to 1.35). In time-varying analyses, a 10-mg/m3 increase in PM2.5 concentration was associated with similarly increased risk of eGFR,60 ml/min per 1.73 m2, CKD, eGFR decline $30%, and ESRD. Spline analyses showed a linear relationship between PM2.5 concentrations and risk of kidney outcomes. Exposure estimates derived from National Aeronautics and Space Administration satellite data yielded consistent results. Our findings demonstrate a significant association between exposure to PM2.5 and risk of incident CKD, eGFR decline, and ESRD.

Published Jan 1, 2018

Bowe, B., Xie, Y., Li, T., Yan, Y., Xian, H., & Al-Aly, Z. (2018). Particulate matter air pollution and the risk of incident CKD and progression to ESRD. Journal of the American Society of Nephrology, 29(1), 218–230. https://doi.org/10.1681/ASN.2017030253