The Effect of Meteorological and Air Pollution Exposures on Health Outcome.
Abstract: Urban air
pollution has a major effect on people's health. The 2010 Global Burden of Disease
review placed outdoor short and long-term exposures to air pollution among the top 10
health risks worldwide, contributing annually to over 3.2 million premature deaths and
more than 74 million years of healthy life lost. Information on the association of air
pollution and meteorological exp... read moreosures with various chronic diseases including Venous
Thromboembolism (VTE), could be used to plan appropriate public health interventions
including the more stringent regulation of air pollution levels or providing advice to
the general public under different weather conditions. Our aims were to examine the
association between short-term air pollution exposures (i.e., PM2.5, PM10, O3) and
meteorological exposures (i.e., atmospheric pressure, temperature, rainfall, humidity,
sunlight, and vapor pressure) and risk of outpatient VTE; To perform a systematic review
of the association of outdoor air quality indices currently in use by governments around
the world with any health outcome using any study designs. We used data from the
Worcester Venous Thromboembolism Study in a time-stratified case-crossover design to
examine the effect of three air pollution exposures (i.e., particulate matter (PM2.5),
nitrogen dioxide, and ozone) and nine meteorological exposures (i.e., barometric
atmospheric pressure, temperature, precipitation, wind speed, relative humidity, cloud
hours, dew-point) and risk of outpatient VTE for lag times of 0-7 days and moving
averages of 2, 7, 14, and 21 days. In addition, we systematically searched the
literature for potentially eligible studies in MEDLINE, EMBASE, Ovid, and the Cochrane
Central Register of Controlled Trials and EBM Reviews (from inception to March 1, 2014).
We identified studies that examined the association of either short or long-term
associations with any air quality indices that are currently in use by government
agencies to communicate air pollution levels to the general public with any health
outcome. We found little association of any of the air pollution exposures we studies
(particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3)) with outpatient VTE
using the Worcester VTE study data during the years 1999-2007. With regard to
meteorological exposures We found associations of daily minimum temperatures, daily mean
relative humidity, mean daily wind speed, mean daily dew-point, precipitation, and mean
daily cloud hours with increased risk of outpatient VTE in some, but not all single days
lags, most commonly in lags single lag times of 4-6 days. Our systematic review found
only a small number of observational studies (n=13) that evaluated the short or long-
term associations of US Air Quality Index (AQI) and Canadian Air Quality Health Index
(AQHI) with an equally small number (N=8) of health outcomes. Our findings need
independent confirmation with other datasets in other areas of the US or around the
world. Understanding the influence of air pollution, season and temperature is valuable
in seeking to determine the need for public health measures to reduce the individual and
population risk for VTE. Based on our systematic review findings, it is difficult to
evaluate whether the US AQI or AQHI are issuing warnings optimally or not when
communicating the health risks associated with air pollution to the general public or
select populations at increased risk for adverse health
Thesis (Ph.D.)--Tufts University, 2014.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Doug Brugge.
Committee: Issa Dahabreh, Robert Goldberg, David Kent, and Frederick Spencer.
Keywords: Epistemology, and Environmental science.read less