Keita Ebisu

Hospital Admissions and Chemical Composition of Fine Particle Air Pollution

RATIONALE There are unexplained geographical and seasonal differences in the short-term effects of fine particulate matter (PM(2.5)) on human health. The hypothesis has been advanced to include the possibility that such differences might be due to variations in the PM(2.5) chemical composition, but evidence supporting this hypothesis is lacking. OBJECTIVES To examine whether variation in the relative risks (RR) of hospitalization associated with ambient exposure to PM(2.5) total mass reflects differences in PM(2.5) chemical composition. METHODS We linked two national datasets by county and by season: (1) long-term average concentrations of PM(2.5) chemical components for 2000-2005 and (2) RRs of cardiovascular and respiratory hospitalizations for persons 65 years or older associated with a 10-microg/m(3) increase in PM(2.5) total mass on the same day for 106 U.S. counties for 1999 through 2005. MEASUREMENTS AND MAIN RESULTS We found a positive and statistically significant association between county-specific estimates of the short-term effects of PM(2.5) on cardiovascular and respiratory hospitalizations and county-specific levels of vanadium, elemental carbon, or nickel PM(2.5) content. CONCLUSIONS Communities with higher PM(2.5) content of nickel, vanadium, and elemental carbon and/or their related sources were found to have higher risk of hospitalizations associated with short-term exposure to PM(2.5).

Spatial and temporal variation in PM2.5 chemical composition in the United States for health effects studies

Background Although numerous studies have demonstrated links between particulate matter (PM) and adverse health effects, the chemical components of the PM mixture that cause injury are unknown. Objectives This work characterizes spatial and temporal variability of PM2.5 (PM with aerodynamic diameter < 2.5 μm) components in the United States; our objective is to identify components for assessment in epidemiologic studies. Methods We constructed a database of 52 PM2.5 component concentrations for 187 U.S. counties for 2000–2005. First, we describe the challenges inherent to analysis of a national PM2.5 chemical composition database. Second, we identify components that contribute substantially to and/or co-vary with PM2.5 total mass. Third, we characterize the seasonal and regional variability of targeted components. Results Strong seasonal and geographic variations in PM2.5 chemical composition are identified. Only seven of the 52 components contributed ≥ 1% to total mass for yearly or seasonal averages [ammonium (NH4+), elemental carbon (EC), organic carbon matter (OCM), nitrate (NO3−), silicon, sodium (Na+), and sulfate (SO42−)]. Strongest correlations with PM2.5 total mass were with NH4+ (yearly), OCM (especially winter), NO3− (winter), and SO42− (yearly, spring, autumn, and summer), with particularly strong correlations for NH4+ and SO42− in summer. Components that co-varied with PM2.5 total mass, based on daily detrended data, were NH4+, SO42−, OCM, NO32−, bromine, and EC. Conclusions The subset of identified PM2.5 components should be investigated further to determine whether their daily variation is associated with daily variation of health indicators, and whether their seasonal and regional patterns can explain the seasonal and regional heterogeneity in PM10 (PM with aerodynamic diameter < 10 μm) and PM2.5 health risks.

Ambient air pollution and low birth weight in Connecticut and Massachusetts.

Background Several studies have examined whether air pollution affects birth weight; however results vary and many studies were focused on Southern California or were conducted outside of the United States. Objectives We investigated maternal exposure to particulate matter with aerodynamic diameter < 10, < 2.5 μm (PM10, PM2.5), sulfur dioxide, nitrogen dioxide, and carbon monoxide and birth weight for 358,504 births in Massachusetts and Connecticut from 1999 to 2002. Methods Analysis included logistic models for low birth weight (< 2,500 g) and linear models with birth weight as a continuous variable. Exposure was assigned as the average county-level concentration over gestation and each trimester based on mother’s residence. We adjusted for gestational length, prenatal care, type of delivery, child’s sex, birth order, weather, year, and mother’s race, education, marital status, age, and tobacco use. Results An interquartile increase in gestational exposure to NO2, CO, PM10, and PM2.5 lowered birth weight by 8.9 g [95% confidence interval (CI), 7.0–10.8], 16.2 g (95% CI, 12.6–19.7), 8.2 g (95% CI, 5.3–11.1), and 14.7 g (95% CI, 12.3–17.1), respectively. Lower birth weight was associated with exposure in the third trimester for PM10, the first and third trimesters for CO, the first trimester for NO2 and SO2, and the second and third trimesters for PM2.5. Effect estimates for PM2.5 were higher for infants of black mothers than those of white mothers. Conclusions Results indicate that exposure to air pollution, even at low levels, may increase risk of low birth weight, particularly for some segments of the population.

Prenatal Exposure to Fine Particulate Matter and Birth Weight: Variations by Particulate Constituents and Sources

Background: Exposure to fine particles (PM2.5) during pregnancy has been linked to lower birth weight; however, the chemical composition of PM2.5 varies widely. The health effects of PM2.5 constituents are unknown. Methods: We investigated whether PM2.5 mass, constituents, and sources are associated with birth weight for term births. PM2.5 filters collected in 3 Connecticut counties and 1 Massachusetts county from August 2000 through February 2004 were analyzed for more than 50 elements. Source apportionment was used to estimate daily contributions of PM2.5 sources, including traffic, road dust/crustal, oil combustion, salt, and regional (sulfur) sources. Gestational and trimester exposure to PM2.5 mass, constituents, and source contributions were examined in relation to birth weight and risk of small-at-term birth (term birth <2500 g) for 76,788 infants. Results: Road dust and related constituents such as silicon and aluminum were associated with lower birth weight, as were the motor-vehicle-related species such as elemental carbon and zinc, and the oil-combustion-associated elements vanadium and nickel. An interquartile range increase in exposure was associated with low birthweight for zinc (12% increase in risk), elemental carbon (13%), silicon (10%), aluminum (11%), vanadium (8%), and nickel (11%). Analysis by trimester showed effects of third-trimester exposure to elemental carbon, nickel, vanadium, and oil-combustion PM2.5. Conclusions: Exposures of pregnant women to higher levels of certain PM2.5 chemical constituents originating from specific sources are associated with lower birth weight.

Environmental inequality in exposures to airborne particulate matter components in the United States.

Background: Growing evidence indicates that toxicity of fine particulate matter ≤ 2.5 μm in diameter (PM2.5) differs by chemical component. Exposure to components may differ by population. Objectives: We investigated whether exposures to PM2.5 components differ by race/ethnicity, age, and socioeconomic status (SES). Methods: Long-term exposures (2000 through 2006) were estimated for 215 U.S. census tracts for PM2.5 and for 14 PM2.5 components. Population-weighted exposures were combined to generate overall estimated exposures by race/ethnicity, education, poverty status, employment, age, and earnings. We compared population characteristics for tracts with and without PM2.5 component monitors. Results: Larger disparities in estimated exposures were observed for components than for PM2.5 total mass. For race/ethnicity, whites generally had the lowest exposures. Non-Hispanic blacks had higher exposures than did whites for 13 of the 14 components. Hispanics generally had the highest exposures (e.g., 152% higher than whites for chlorine, 94% higher for aluminum). Young persons (0–19 years of age) had levels as high as or higher than other ages for all exposures except sulfate. Persons with lower SES had higher estimated exposures, with some exceptions. For example, a 10% increase in the proportion unemployed was associated with a 20.0% increase in vanadium and an 18.3% increase in elemental carbon. Census tracts with monitors had more non-Hispanic blacks, lower education and earnings, and higher unemployment and poverty than did tracts without monitors. Conclusions: Exposures to PM2.5 components differed by race/ethnicity, age, and SES. If some components are more toxic than others, certain populations are likely to suffer higher health burdens. Demographics differed between populations covered and not covered by monitors.

Associations of PM2.5 Constituents and Sources with Hospital Admissions: Analysis of Four Counties in Connecticut and Massachusetts (USA) for Persons ≥ 65 Years of Age

Background: Epidemiological studies have demonstrated associations between short-term exposure to PM2.5 and hospital admissions. The chemical composition of particles varies across locations and time periods. Identifying the most harmful constituents and sources is an important health and regulatory concern. Objectives: We examined pollutant sources for associations with risk of hospital admissions for cardiovascular and respiratory causes. Methods: We obtained PM2.5 filter samples for four counties in Connecticut and Massachusetts and analyzed them for PM2.5 elements. Source apportionment was used to estimate daily PM2.5 contributions from sources (traffic, road dust, oil combustion, and sea salt as well as a regional source representing coal combustion and other sources). Associations between daily PM2.5 constituents and sources and risk of cardiovascular and respiratory hospitalizations for the Medicare population (> 333,000 persons ≥ 65 years of age) were estimated with time-series analyses (August 2000–February 2004). Results: PM2.5 total mass and PM2.5 road dust contribution were associated with cardiovascular hospitalizations, as were the PM2.5 constituents calcium, black carbon, vanadium, and zinc. For respiratory hospitalizations, associations were observed with PM2.5 road dust, and sea salt as well as aluminum, calcium, chlorine, black carbon, nickel, silicon, titanium, and vanadium. Effect estimates were generally robust to adjustment by co-pollutants of other constituents. An interquartile range increase in same-day PM2.5 road dust (1.71 μg/m3) was associated with a 2.11% (95% CI: 1.09, 3.15%) and 3.47% (95% CI: 2.03, 4.94%) increase in cardiovascular and respiratory admissions, respectively. Conclusions: Our results suggest some particle sources and constituents are more harmful than others and that in this Connecticut/Massachusetts region the most harmful particles include black carbon, calcium, and road dust PM2.5. Citation: Bell ML, Ebisu K, Leaderer BP, Gent JF, Lee HJ, Koutrakis P, Wang Y, Dominici F, Peng RD. 2014. Associations of PM2.5 constituents and sources with hospital admissions: analysis of four counties in Connecticut and Massachusetts (USA) for persons ≥ 65 years of age. Environ Health Perspect 122:138–144; http://dx.doi.org/10.1289/ehp.1306656

Adverse Health Effects of Particulate Air Pollution: Modification by Air Conditioning

Background: The short-term effects of particulate matter (PM) on mortality and morbidity differ by geographic location and season. Several hypotheses have been proposed for this variation, including different exposures with air conditioning (AC) versus open windows. Methods: Bayesian hierarchical modeling was used to explore whether AC prevalence modified day-to-day associations between PM10 and mortality, and between PM2.5 and cardiovascular or respiratory hospitalizations, for those 65 years and older. We considered yearly, summer-only, and winter-only effect estimates and 2 types of AC (central and window units). Results: Communities with higher AC prevalence had lower PM effects. Associations were observed for cardiovascular hospitalizations and central AC. Each additional 20% of households with central AC was associated with a 43% decrease in PM2.5 effects on cardiovascular hospitalization. Central AC prevalence explained 17% of between-community variability in PM2.5 effect estimates for cardiovascular hospitalizations. Conclusions: Higher AC prevalence was associated with lower health effect estimates for PM.

Airborne PM2.5 Chemical Components and Low Birth Weight in the Northeastern and Mid-Atlantic Regions of the United States

Background: Previous studies on air pollutants and birth outcomes have reported inconsistent results. Chemical components of particulate matter ≤ 2.5 µm (PM2.5) composition are spatially -heterogeneous, which might contribute to discrepancies across PM2.5 studies. Objectives: We explored whether birth weight at term is affected by PM2.5, PM10 (PM ≤ 10 µm), and gaseous pollutants. Methods: We calculated exposures during gestation and each trimester for PM2.5 chemical components, PM10, PM2.5, carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide for births in 2000–2007 for states in the northeastern and mid-Atlantic United States. Associations between exposures and risk of low birth weight (LBW) were adjusted by family and individual characteristics and region. Interaction terms were used to investigate whether risk differs by race or sex. Results: Several PM2.5 chemical components were associated with LBW. Risk increased 4.9% (95% CI: 3.4, 6.5%), 4.7% (3.2, 6.2%), 5.7% (2.7, 8.8%), and 5.0% (3.1, 7.0%) per interquartile range increase of PM2.5 aluminum, elemental carbon, nickel, and titanium, respectively. Other PM2.5 chemical components and gaseous pollutants showed associations, but were not statistically significant in multipollutant models. The trimester associated with the highest relative risk differed among pollutants. Effect estimates for PM2.5 elemental carbon and nickel were higher for infants of white mothers than for those of African-American mothers, and for males than females. Conclusions: Most exposure levels in our study area were in compliance with U.S. Environmental Protection Agency air pollution standards; however, we identified associations between PM2.5 components and LBW. Findings suggest that some PM2.5 components may be more harmful than others, and that some groups may be particularly susceptible.

PM2.5 exposure and birth outcomes: Use of satellite- and monitor-based data

Background: Air pollution may be related to adverse birth outcomes. Exposure information from land-based monitoring stations often suffers from limited spatial coverage. Satellite data offer an alternative data source for exposure assessment. Methods: We used birth certificate data for births in Connecticut and Massachusetts, United States (2000–2006). Gestational exposure to PM2.5 was estimated from US Environmental Protection Agency monitoring data and from satellite data. Satellite data were processed and modeled by using two methods—denoted satellite (1) and satellite (2)—before exposure assessment. Regression models related PM2.5 exposure to birth outcomes while controlling for several confounders. Birth outcomes were mean birth weight at term birth, low birth weight at term (<2500 g), small for gestational age (SGA, <10th percentile for gestational age and sex), and preterm birth (<37 weeks). Results: Overall, the exposure assessment method modified the magnitude of the effect estimates of PM2.5 on birth outcomes. Change in birth weight per interquartile range (2.41 &mgr;g/m3) increase in PM2.5 was −6 g (95% confidence interval = −8 to −5), −16 g (−21 to −11), and −19 g (−23 to −15), using the monitor, satellite (1), and satellite (2) methods, respectively. Adjusted odds ratios, based on the same three exposure methods, for term low birth weight were 1.01 (0.98–1.04), 1.06 (0.97–1.16), and 1.08 (1.01–1.16); for SGA, 1.03 (1.01–1.04), 1.06 (1.03–1.10), and 1.08 (1.04–1.11); and for preterm birth, 1.00 (0.99–1.02), 0.98 (0.94–1.03), and 0.99 (0.95–1.03). Conclusions: Under exposure assessment methods, we found associations between PM2.5 exposure and adverse birth outcomes particularly for birth weight among term births and for SGA. These results add to the growing concerns that air pollution adversely affects infant health and suggest that analysis of health consequences based on satellite-based exposure assessment can provide additional useful information.

Community-level spatial heterogeneity of chemical constituent levels of fine particulates and implications for epidemiological research.

Studies of the health impacts of airborne particulates’ chemical constituents typically assume spatial homogeneity and estimate exposure from ambient monitors. However, factors such as local sources may cause spatially heterogeneous pollution levels. This work examines the degree to which constituent levels vary within communities and whether exposure misclassification is introduced by spatial homogeneity assumptions. Analysis considered PM2.5 elemental carbon (EC), organic carbon matter, ammonium, sulfate, nitrate, silicon, and sodium ion (Na+) for the United States, 1999–2007. Pearson correlations and coefficients of divergence were calculated and compared to distances among monitors. Linear modeling related correlations to distance between monitors, long-term constituent levels, and population density. Spatial heterogeneity was present for all constituents, yet lower for ammonium, sulfate, and nitrate. Lower correlations were associated with higher distance between monitors, especially for nitrate and sulfate, and with lower long-term levels, especially for sulfate and Na+. Analysis of colocated monitors revealed measurement error for all constituents, especially EC and Na+. Exposure misclassification may be introduced into epidemiological studies of PM2.5 constituents due to spatial variability, and is affected by constituent type and level. When assessing health effects of PM constituents, new methods are needed for estimating exposure and accounting for exposure error induced by spatial variability.