Jessie L.C. Shmool

Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures

BackgroundRecent toxicological and epidemiological evidence suggests that chronic psychosocial stress may modify pollution effects on health. Thus, there is increasing interest in refined methods for assessing and incorporating non-chemical exposures, including social stressors, into environmental health research, towards identifying whether and how psychosocial stress interacts with chemical exposures to influence health and health disparities. We present a flexible, GIS-based approach for examining spatial patterns within and among a range of social stressors, and their spatial relationships with air pollution, across New York City, towards understanding their combined effects on health.MethodsWe identified a wide suite of administrative indicators of community-level social stressors (2008–2010), and applied simultaneous autoregressive models and factor analysis to characterize spatial correlations among social stressors, and between social stressors and air pollutants, using New York City Community Air Survey (NYCCAS) data (2008-2009). Finally, we provide an exploratory ecologic analysis evaluating possible modification of the relationship between nitrogen dioxide (NO2) and childhood asthma Emergency Department (ED) visit rates by social stressors, to demonstrate how the methods used to assess stressor exposure (and/or consequent psychosocial stress) may alter model results.ResultsAdministrative indicators of a range of social stressors (e.g., high crime rate, residential crowding rate) were not consistently correlated (rho = - 0.44 to 0.89), nor were they consistently correlated with indicators of socioeconomic position (rho = - 0.54 to 0.89). Factor analysis using 26 stressor indicators suggested geographically distinct patterns of social stressors, characterized by three factors: violent crime and physical disorder, crowding and poor access to resources, and noise disruption and property crimes. In an exploratory ecologic analysis, these factors were differentially associated with area-average NO2 and childhood asthma ED visits. For example, only the ‘violent crime and disorder’ factor was significantly associated with asthma ED visits, and only the ‘crowding and resource access’ factor modified the association between area-level NO2 and asthma ED visits.ConclusionsThis spatial approach enabled quantification of complex spatial patterning and confounding between chemical and non-chemical exposures, and can inform study design for epidemiological studies of separate and combined effects of multiple urban exposures.

Ambient Fine Particulate Matter, Nitrogen Dioxide, and Preterm Birth in New York City.

Background: Recent studies have suggested associations between air pollution and various birth outcomes, but the evidence for preterm birth is mixed. Objective: We aimed to assess the relationship between air pollution and preterm birth using 2008–2010 New York City (NYC) birth certificates linked to hospital records. Methods: We analyzed 258,294 singleton births with 22–42 completed weeks gestation to nonsmoking mothers. Exposures to ambient fine particles (PM2.5) and nitrogen dioxide (NO2) during the first, second, and cumulative third trimesters within 300 m of maternal address were estimated using data from the NYC Community Air Survey and regulatory monitors. We estimated the odds ratio (OR) of spontaneous preterm (gestation < 37 weeks) births for the first- and second-trimester exposures in a logistic mixed model, and the third-trimester cumulative exposures in a discrete time survival model, adjusting for maternal characteristics and delivery hospital. Spatial and temporal components of estimated exposures were also separately analyzed. Results: PM2.5 was not significantly associated with spontaneous preterm birth. NO2 in the second trimester was negatively associated with spontaneous preterm birth in the adjusted model (OR = 0.90; 95% CI: 0.83, 0.97 per 20 ppb). Neither pollutant was significantly associated with spontaneous preterm birth based on adjusted models of temporal exposures, whereas the spatial exposures showed significantly reduced odds ratios (OR = 0.80; 95% CI: 0.67, 0.96 per 10 μg/m3 PM2.5 and 0.88; 95% CI: 0.79, 0.98 per 20 ppb NO2). Without adjustment for hospital, these negative associations were stronger. Conclusion: Neither PM2.5 nor NO2 was positively associated with spontaneous preterm delivery in NYC. Delivery hospital was an important spatial confounder. Citation: Johnson S, Bobb JF, Ito K, Savitz DA, Elston B, Shmool JL, Dominici F, Ross Z, Clougherty JE, Matte T. 2016. Ambient fine particulate matter, nitrogen dioxide, and preterm birth in New York City. Environ Health Perspect 124:1283–1290; http://dx.doi.org/10.1289/ehp.1510266

Spatial variation in inversion-focused vs 24-h integrated samples of PM 2.5 and black carbon across Pittsburgh, PA

A growing literature explores intra-urban variation in pollution concentrations. Few studies, however, have examined spatial variation during “peak” hours of the day (e.g., rush hours, inversion conditions), which may have strong bearing for source identification and epidemiological analyses. We aimed to capture “peak” spatial variation across a region of complex terrain, legacy industry, and frequent atmospheric inversions. We hypothesized stronger spatial contrast in concentrations during hours prone to atmospheric inversions and heavy traffic, and designed a 2-year monitoring campaign to capture spatial variation in fine particles (PM2.5) and black carbon (BC). Inversion-focused integrated monitoring (0600–1100 hours) was performed during year 1 (2011–2012) and compared with 1-week 24-h integrated results from year 2 (2012–2013). To allocate sampling sites, we explored spatial distributions in key sources (i.e., traffic, industry) and potential modifiers (i.e., elevation) in geographic information systems (GIS), and allocated 37 sites for spatial and source variability across the metropolitan domain (~388 km2). Land use regression (LUR) models were developed and compared by pollutant, season, and sampling method. As expected, we found stronger spatial contrasts in PM2.5 and BC using inversion-focused sampling, suggesting greater differences in peak exposures across urban areas than is captured by most integrated saturation campaigns. Temporal variability, commercial and industrial land use, PM2.5 emissions, and elevation were significant predictors, but did not more strongly predict concentrations during peak hours.

Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City.

Background: Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions. Methods: We linked birth certificates in New York City in 2008–2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births. Results: In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes. Conclusions: Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association.

Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City

There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

The Role of Non-Chemical Stressors in Mediating Socioeconomic Susceptibility to Environmental Chemicals

Growing evidence suggests that lower socioeconomic position (SEP) communities may be more susceptible to environmental exposures. SEP, however, represents a complex mix of social and environmental exposures accumulating over the lifecourse, and those components that most impact susceptibility remain undetermined. One plausible hypothesis is that the chronic psychological stress associated with stressors in many lower-SEP communities (e.g., housing instability, food insecurity, fear of violence) may lead to altered immune, endocrine, and metabolic function. These alterations, together with environmental exposures, may ultimately contribute to increased risk of developing a variety of chronic diseases.Clearer insight into which specific components of SEP may magnify susceptibility to toxic environmental exposures is needed to improve epidemiologic analyses, and to design more effective environmental health policies and interventions. Here, we compile recent evidence published since 2009, when we conducted a similar review of this topic, towards developing a better understanding of chronic stress as a possible mediator of SEP-related pollution susceptibility. We discuss recent findings on common patterning (i.e., spatial correlation) between these exposures and methodological needs to facilitate disentangling health effects of non-chemical and chemical stressors. Finally, we briefly discuss the implications of disentangling SEP- and stress-related susceptibility for cumulative risk assessment.

Spatial patterning in PM2.5 constituents under an inversion-focused sampling design across an urban area of complex terrain.

Health effects of fine particulate matter (PM2.5) vary by chemical composition, and composition can help to identify key PM2.5 sources across urban areas. Further, this intra-urban spatial variation in concentrations and composition may vary with meteorological conditions (e.g., mixing height). Accordingly, we hypothesized that spatial sampling during atmospheric inversions would help to better identify localized source effects, and reveal more distinct spatial patterns in key constituents. We designed a 2-year monitoring campaign to capture fine-scale intra-urban variability in PM2.5 composition across Pittsburgh, PA, and compared both spatial patterns and source effects during “frequent inversion” hours vs 24-h weeklong averages. Using spatially distributed programmable monitors, and a geographic information systems (GIS)-based design, we collected PM2.5 samples across 37 sampling locations per year to capture variation in local pollution sources (e.g., proximity to industry, traffic density) and terrain (e.g., elevation). We used inductively coupled plasma mass spectrometry (ICP-MS) to determine elemental composition, and unconstrained factor analysis to identify source suites by sampling scheme and season. We examined spatial patterning in source factors using land use regression (LUR), wherein GIS-based source indicators served to corroborate factor interpretations. Under both summer sampling regimes, and for winter inversion-focused sampling, we identified six source factors, characterized by tracers associated with brake and tire wear, steel-making, soil and road dust, coal, diesel exhaust, and vehicular emissions. For winter 24-h samples, four factors suggested traffic/fuel oil, traffic emissions, coal/industry, and steel-making sources. In LURs, as hypothesized, GIS-based source terms better explained spatial variability in inversion-focused samples, including a greater contribution from roadway, steel, and coal-related sources. Factor analysis produced source-related constituent suites under both sampling designs, though factors were more distinct under inversion-focused sampling.

Area-level socioeconomic deprivation, nitrogen dioxide exposure, and term birth weight in New York City.

Numerous studies have linked air pollution with adverse birth outcomes, but relatively few have examined differential associations across the socioeconomic gradient. To evaluate interaction effects of gestational nitrogen dioxide (NO2) and area-level socioeconomic deprivation on fetal growth, we used: (1) highly spatially-resolved air pollution data from the New York City Community Air Survey (NYCCAS); and (2) spatially-stratified principle component analysis of census variables previously associated with birth outcomes to define area-level deprivation. New York City (NYC) hospital birth records for years 2008-2010 were restricted to full-term, singleton births to non-smoking mothers (n=243,853). We used generalized additive mixed models to examine the potentially non-linear interaction of nitrogen dioxide (NO2) and deprivation categories on birth weight (and estimated linear associations, for comparison), adjusting for individual-level socio-demographic characteristics and sensitivity testing adjustment for co-pollutant exposures. Estimated NO2 exposures were highest, and most varying, among mothers residing in the most-affluent census tracts, and lowest among mothers residing in mid-range deprivation tracts. In non-linear models, we found an inverse association between NO2 and birth weight in the least-deprived and most-deprived areas (p-values<0.001 and 0.05, respectively) but no association in the mid-range of deprivation (p=0.8). Likewise, in linear models, a 10 ppb increase in NO2 was associated with a decrease in birth weight among mothers in the least-deprived and most-deprived areas of -16.2g (95% CI: -21.9 to -10.5) and -11.0 g (95% CI: -22.8 to 0.9), respectively, and a non-significant change in the mid-range areas [β=0.5 g (95% CI: -7.7 to 8.7)]. Linear slopes in the most- and least-deprived quartiles differed from the mid-range (reference group) (p-values<0.001 and 0.09, respectively). The complex patterning in air pollution exposure and deprivation in NYC, however, precludes simple interpretation of interactive effects on birth weight, and highlights the importance of considering differential distributions of air pollution concentrations, and potential differences in susceptibility, across deprivation levels.

Spatial variation in diesel-related elemental and organic PM2.5 components during workweek hours across a downtown core.

Capturing intra-urban variation in diesel-related pollution exposures remains a challenge, given its complex chemical mix, and relatively few well-characterized ambient-air tracers for the multiple diesel sources in densely-populated urban areas. To capture fine-scale spatial resolution (50×50m grid cells) in diesel-related pollution, we used geographic information systems (GIS) to systematically allocate 36 sampling sites across downtown Pittsburgh, PA, USA (2.8km2), cross-stratifying to disentangle source impacts (i.e., truck density, bus route frequency, total traffic density). For buses, outbound and inbound trips per week were summed by route and a kernel density was calculated across sites. Programmable monitors collected fine particulate matter (PM2.5) samples specific to workweek hours (Monday-Friday, 7 am-7 pm), summer and winter 2013. Integrated filters were analyzed for black carbon (BC), elemental carbon (EC), organic carbon (OC), elemental constituents, and diesel-related organic compounds [i.e., polycyclic aromatic hydrocarbons (PAHs), hopanes, steranes]. To our knowledge, no studies have collected this suite of pollutants with such high sampling density, with the ability to capture spatial patterns during specific hours of interest. We hypothesized that we would find substantial spatial variation for each pollutant and significant associations with key sources (e.g. diesel and gasoline vehicles), with higher concentrations near the center of this small downtown core. Using a forward stepwise approach, we developed seasonal land use regression (LUR) models for PM2.5, BC, total EC, OC, PAHs, hopanes, steranes, aluminum (Al), calcium (Ca), and iron (Fe). Within this small domain, greater concentration differences were observed in most pollutants across sites, on average, than between seasons. Higher PM2.5 and BC concentrations were found in the downtown core compared to the boundaries. PAHs, hopanes, and steranes displayed different spatial patterning across the study area by constituent. Most LUR models suggested a strong influence of bus-related emissions on pollution gradients. Buses were more dominant predictors compared to truck and vehicular traffic for several pollutants. Overall, we found substantial variation in diesel-related concentrations in a very small downtown area, which varied across elemental and organic components.

Is All Urban Green Space the Same? A Comparison of the Health Benefits of Trees and Grass in New York City

Living near vegetation, often called “green space” or “greenness”, has been associated with numerous health benefits. We hypothesized that the two key components of urban vegetation, trees and grass, may differentially affect health. We estimated the association between near-residence trees, grass, and total vegetation (from the 2010 High Resolution Land Cover dataset for New York City (NYC)) with self-reported health from a survey of NYC adults (n = 1281). We found higher reporting of “very good” or “excellent” health for respondents with the highest, compared to the lowest, quartiles of tree (RR = 1.23, 95% CI = 1.06–1.44) but not grass density (relative risk (RR) = 1.00, 95% CI = 0.86–1.17) within 1000 m buffers, adjusting for pertinent confounders. Significant positive associations between trees and self-reported health remained after adjustment for grass, whereas associations with grass remained non-significant. Adjustment for air pollutants increased beneficial associations between trees and self-reported health; adjustment for parks only partially attenuated these effects. Results were null or negative using a 300 m buffer. Findings imply that higher exposure to vegetation, particularly trees outside of parks, may be associated with better health. If replicated, this may suggest that urban street tree planting may improve population health.