Assessment of the Health Impacts of Particulate Matter Characteristics

Walter A. Rosenblith New Investigator RESEARCH REPORT HEA L TH HEA L TH Assessment of the Health EFFE CTS EFFE CTS INSTITUTE INSTITUTE Impacts of Particulate 101 Federal Street, Suite 500 Matter Characteristics Boston, MA 02110, USA Number 161 +1-617-488-2300 January 2012 Michelle L. Bell www.healtheffects.org RESEARCH REPORT Number 161 January 2012 Includes a Commentary by the Institute’s Health Review Committee January 2004 January Assessment of the Health Impacts of Particulate Matter Characteristics Michelle L. Bell with a Commentary by the HEI Health Review Committee Research Report 161 Health Effects Institute Boston, Massachusetts Trusted Science · Cleaner Air · Better Health Publishing history: This document was posted at www.healtheffects.org in January 2012. Citation for document: Bell ML. 2012. Assessment of the Health Impacts of Particulate Matter Characteristics. Research Report 161. Health Effects Institute, Boston, MA. © 2012 Health Effects Institute, Boston, Mass., U.S.A. Cameographics, Belfast, Me., Compositor. Printed by Recycled Paper Printing, Boston, Mass. Library of Congress Catalog Number for the HEI Report Series: WA 754 R432. Cover paper: made with at least 55% recycled content, of which at least 30% is post-consumer waste; free of acid and elemental chlorine. Text paper: made with 100% post-consumer waste recycled content; acid free; no chlorine used in processing. The book is printed with soy-based inks and is of permanent archival quality. CONTENTS About HEI v About This Report vii HEI STATEMENT 1 INVESTIGATOR’S REPORT by Bell 5 ABSTRACT 5 INTRODUCTION 6 SPECIFIC AIMS 7 METHODS 8 Spatial and Temporal Variation in PM2.5 Chemical Composition 8 Evaluation of Spatial and Temporal Patterns in the Association Between Short-Term Exposure to PM2.5 and Hospital Admissions 9 Evaluation of Whether Spatial and Temporal Patterns in PM Total Mass Health Effect Estimates Are Related to Spatial and Temporal Patterns in PM Chemical Composition 11 RESULTS 12 Spatial and Temporal Variation in PM2.5 Chemical Composition 12 Seasonal and Regional Effects of PM2.5 on Cardiovascular- and Respiratory-Related Hospital Admissions 18 Analysis of Spatial and Temporal Heterogeneity in PM Total Mass Health Effect Estimates and Spatial and Temporal Patterns in PM Chemical Composition 20 CONCLUSIONS AND IMPLICATIONS 27 ACKNOWLEDGMENTS 29 REFERENCES 29 APPENDIX A. HEI Quality Assurance Statement 33 APPENDIX B. Abstracts of Other Publications Resulting from This Research 33 APPENDIX AVAILABLE ON THE WEB 37 ABOUT THE AUTHOR 37 OTHER PUBLICATIONS RESULTING FROM THIS RESEARCH 37 ABBREVIATIONS AND OTHER TERMS 38 Elements 38 COMMENTARY by the Health Review Committee 39 INTRODUCTION 39 SCIENTIFIC BACKGROUND 39 Research Report 161 STUDY SUMMARY 41 Study Objectives 41 Methods 41 Sources and Compilation of Data 41 Statistical Analyses 43 KEY FINDINGS 44 Spatial and Temporal Variation in the Chemical Composition of PM2.5 (Specific Aim 1) 44 Spatial and Temporal Patterns in Associations Between Short-Term PM2.5 Exposures and Hospital Admissions (Specific Aim 2) 45 National Health Effects Estimates — Main and Seasonal Models 45 Regional Health Effects Estimates — All Three Models 45 Analysis of Spatial and Temporal Patterns in PM Total Mass Health Effect Estimates and Spatial and Temporal Hetero- geneity in PM2.5 Chemical Composition (Specific Aim 3) 46 Hospitalization Results 46 Mortality Results 46 Sensitivity of Component Effects to County or Community 46 Sensitivity of Component Effects to Adjustment for Other PM Components 46 Sensitivity of PM Total Mass Effect Estimates to County- or Community-Level Variables 46 HEI EVALUATION OF THE STUDY 46 Spatial and Temporal Variation in PM2.5 Composition 47 SIDEBAR Investigating the Effects of PM Components on Health: Two Approaches 47 Estimation of PM2.5 Associations with Cardiovascular and Respiratory Diseases 48 Understanding the Role of PM2.5 Composition in Explaining Health Effects Associated with PM Total Mass 49 PM2.5 Components and Hospital Admissions 49 PM2.5 Components and Mortality 50 Other Methodologic Considerations for the Epidemiologic Analyses of PM2.5 Components 51 Discussion 51 CONCLUSIONS 52 ACKNOWLEDGMENTS 52 REFERENCES 53 Related HEI Publications: Particulate Matter 55 HEI Board, Committees, and Staff 57 ABOUT HEI The Health Effects Institute is a nonprofit corporation chartered in 1980 as an independent research organization to provide high-quality, impartial, and relevant science on the effects of air pollution on health. To accomplish its mission, the institute • Identifies the highest-priority areas for health effects research; • Competitively funds and oversees research projects; • Provides intensive independent review of HEI-supported studies and related research; • Integrates HEI’s research results with those of other institutions into broader evaluations; and • Communicates the results of HEI’s research and analyses to public and private decision makers. HEI typically receives half of its core funds from the U.S. Environmental Protection Agency and half from the worldwide motor vehicle industry. Frequently, other public and private organizations in the United States and around the world also support major projects or research programs. HEI has funded more than 280 research projects in North America, Europe, Asia, and Latin America, the results of which have informed decisions regarding carbon monoxide, air toxics, nitrogen oxides, diesel exhaust, ozone, particulate matter, and other pollutants. These results have appeared in the peer-reviewed literature and in more than 200 comprehensive reports published by HEI. HEI’s independent Board of Directors consists of leaders in science and policy who are committed to fostering the public–private partnership that is central to the organization. The Health Research Committee solicits input from HEI sponsors and other stakeholders and works with scientific staff to develop a Five-Year Strategic Plan, select research projects for funding, and oversee their conduct. The Health Review Committee, which has no role in selecting or overseeing studies, works with staff to evaluate and interpret the results of funded studies and related research. All project results and accompanying comments by the Health Review Committee are widely disseminated through HEI’s Web site (www.healtheffects.org), printed reports, newsletters and other publications, annual conferences, and presentations to legislative bodies and public agencies. v ABOUT THIS REPORT Research Report 161, Assessment of the Health Impacts of Particulate Matter Characteristics, presents a research project funded by the Health Effects Institute and conducted by Dr. Michelle L. Bell of the School of Forestry & Environmental Studies and School of Public Health, Yale University, New Haven, Connecticut. This research was funded under HEI’s Walter A. Rosenblith New Investigator Award Program, which provides support to promising scientists in the early stages of their careers. The report contains three main sections. The HEI Statement, prepared by staff at HEI, is a brief, nontechnical summary of the study and its findings; it also briefly describes the Health Review Committee’s comments on the study. The Investigator’s Report, prepared by Bell, describes the scientific background, aims, methods, results, and conclusions of the study. The Commentary is prepared by members of the Health Review Committee with the assistance of HEI staff; it places the study in a broader scientific context, points out its strengths and limitations, and discusses remaining uncertainties and implications of the study’s findings for public health and future research. This report has gone through HEI’s rigorous review process. When an HEI-funded study is completed, the investigators submit a draft final report presenting the background and results of the study. This draft report is first examined by outside technical reviewers and a biostatistician. The report and the reviewers’ comments are then evaluated by members of the Health Review Committee, an independent panel of distinguished scientists who have no involvement in selecting or overseeing HEI studies. During the review process, the investigators have an opportunity to exchange comments with the Review Committee and, as necessary, to revise their report. The Commentary reflects the information provided in the final version of the report. vii HEI STATEMENT Synopsis of Research Report 161 Assessment of the Health Impacts of Particulate Matter Characteristics BACKGROUND work under HEI’s Walter A. Rosenblith New Inves- Over the past several decades, epidemiologic tigator Award. studies in diverse locations across the United States and other parts of the world have reported associa- APPROACH tions between daily increases in low levels of Bell’s approach to investigating the relationship ambient particulate matter (PM) mass and daily between the chemical components of PM and increases in morbidity and mortality. On the basis human health involved three broad steps. She of these and other findings, many governmental began by characterizing how the chemical composi- agencies have set regulatory standards or guidelines tion of PM2.5 varies regionally and seasonally in the for PM based on the concentration of its mass in United States. Next, she evaluated whether the ambient air. associations between short-term exposure to PM However, scientists have long known that ambient total mass and health effects followed regional and PM is actually a complex mixture

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