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BACKGROUND: Climate change has increased the frequency and intensity of extremely hot weather. The health risks associated with extemely hot weather are not uniform across affected areas owing to variability in heat exposure and social vulnerability, but these differences are challenging to map with precision. OBJECTIVES: We developed a spatially and temporally stratified case-crossover approach for delineation of areas with higher and lower risks of mortality on extremely hot days and applied this approach in greater Vancouver, Canada. METHODS: Records of all deaths with an extremely hot day as a case day or a control day were extracted from an administrative vital statistics database spanning the years of 1998 -- 2014. Three heat exposure and 11 social vulnerability variables were assigned at the residential location of each decedent. Conditional logistic regression was used to estimate the odds ratio for a 1°C increase in daily mean temperature at a fixed site with an interaction term for decedents living above and below different values of the spatial variables. RESULTS: The heat exposure and social vulnerability variables with the strongest spatially stratified results were the apparent temperature and the labor nonparticipation rate, respectively. Areas at higher risk had values ≥ 34.4°C for the maximum apparent temperature and ≥ 60% of the population neither employed nor looking for work. These variables were combined in a composite index to quantify their interaction and to enhance visualization of high-risk areas. CONCLUSIONS: Our methods provide a data-driven framework for spatial delineation of the temperature -- mortality relationship by heat exposure and social vulnerability. The results can be used to map and target the most vulnerable areas for public health intervention. CITATION: Ho HC, Knudby A, Walker BB, Henderson SB. 2017. Delineation of spatial variability in the temperature -- mortality relationship on extremely hot days in greater Vancouver, Canada. Environ Health Perspect 125:66-75; http://dx.doi.org/10.1289/EHP224 [ABSTRACT FROM AUTHOR]

BACKGROUND: Although many time-series studies have established associations of daily pollution variations with daily deaths, there are fewer at low concentrations, or focused on locally generated pollution, which is becoming more important as regulations reduce regional transport. Causal modeling approaches are also lacking. OBJECTIVE: We used causal modeling to estimate the impact of local air pollution on mortality at low concentrations. METHODS: Using an instrumental variable approach, we developed an instrument for variations in local pollution concentrations that is unlikely to be correlated with other causes of death, and examined its association with daily deaths in the Boston, Massachusetts, area. We combined height of the planetary boundary layer and wind speed, which affect concentrations of local emissions, to develop the instrument for particulate matter ≥2.5 μm (PM[sub 2.5]), black carbon (BC), or nitrogen dioxide (NO2) variations that were independent of year, month, and temperature. We also used Granger causality to assess whether omitted variable confounding existed. RESULTS: We estimated that an interquartile range increase in the instrument for local PM[sub 2.5] was associated with a 0.90% increase in daily deaths (95% CI: 0.25, 1.56). A similar result was found for BC, and a weaker association with NO[sub 2] The Granger test found no evidence of omitted variable confounding for the instrument. A separate test confirmed the instrument was not associated with mortality independent of pollution. Furthermore, the association remained when all days with PM[sub 2.5] concentrations > 30 μg/m[sup 3] were excluded from the analysis (0.84% increase in daily deaths; 95% CI: 0.19, 1.50). CONCLUSIONS: We conclude that there is a causal association of local air pollution with daily deaths at concentrations below U.S. EPA standards. The estimated attributable risk in Boston exceeded 1,800 deaths during the study period, indicating that important public health benefits can follow from further control efforts. CITATION: Schwartz J, Bind MA, Koutrakis P. 2017. Estimating causal effects of local air pollution on daily deaths: effect of low levels. Environ Health Perspect 125:23-29; http://dx.doi. org/10.1289/EHP232 [ABSTRACT FROM AUTHOR]

BACKGROUND: High temperatures have substantial impacts on mortality and, with growing concerns about climate change, numerous studies have developed projections of future heat-related deaths around the world. Projections of temperature-related mortality are often limited by insufficient information to formulate hypotheses about population sensitivity to high temperatures and fixture demographics. OBJECTIVES: The present study derived projections of temperature-related mortality in New York City by taking into account future patterns of adaptation or demographic change, both of which can have profound influences on fixture health burdens. METHODS: We adopted a novel approach to modeling heat adaptation by incorporating an analysis of the observed population response to heat in New York City over the course of eight decades. This approach projected heat-related mortality until the end of the 21st century based on observed trends in adaptation over a substantial portion of the 20th century. In addition, we incorporated a range of new scenarios for population change until the end of the 21st century. We then estimated future heat-related deaths in New York City by combining the changing temperature -- mortality relationship and population scenarios with downscaled temperature projections from the 33 global climate models (GCMs) and two Representative Concentration Pathways (RCPs). RESULTS: The median number of projected annual heat-related deaths across the 33 GCMs varied greatly by RCP and adaptation and population change scenario, ranging from 167 to 3,331 in the 2080s compared with 638 heat-related deaths annually between 2000 and 2006. CONCLUSIONS: These findings provide a more complete picture of the range of potential future heat-related mortality risks across the 21st century in New York City, and they highlight the importance of both demographic change and adaptation responses in modifying future risks. CITATION: Petkova EP, Vink JK, Horton RM, Gasparrini A, Bader DA, Francis JD, Kinney PL. 2017. Towards more comprehensive projections of urban heat-related mortality: estimates for New York City under multiple population, adaptation, and climate scenarios. Environ Health Perspect 125:47-55; http://dx.doi.org/10.1289/EHPl66 [ABSTRACT FROM AUTHOR]

BACKGROUND: The ashes and dust resulting from the 2011 eruptions of the Puyehue volcano in Chile more than doubled monthly averages of PM10 concentrations in Montevideo, Uruguay. Few studies have taken advantage of natural experiments to assess the relationship between ambient air pollutant concentrations and birth outcomes. OBJECTIVES: In this study we explored the effect of particulate matter with diameter of ≤ 10 μm (PM10) on perinatal outcomes in Uruguay, a middle-income country in South America with levels of PM10 that in general do not exceed the recommended thresholds. The analyzed outcomes are preterm birth, term birth weight, and term low birth weight. METHODS: We took advantage of the sharp variation in PM10 concentrations due to the Puyehue eruptions to estimate the associations between mother's exposure to PM10 in each trimester of pregnancy and perinatal outcomes. We use birth registries for 2010-2013 and control for covariates, including maternal and pregnancy characteristics, weather, co-pollutants, and calendar quarter and hospital indicators. RESULTS: A 10-μg/m3 increase in exposure to PM10 during the third trimester was associated with a higher likelihood of a preterm birth [odds ratio (OR) = 1.10; 95% CI: 1.03, 1.19]. The association was robust to different model specifications, and increased with categorical exposure levels (OR for third-trimester PM10 ≥ 70 vs. < 30 μg/m3 = 5.24; 95% CI: 3.40, 8.08). Exposures were not consistently associated with birth weight or low birth weight among term births, though second-trimester exposures were associated with higher birth weight, contrary to expectations. CONCLUSIONS: Taking advantage of a natural experiment, we found evidence that exposure to high levels of PM10 during the third trimester of pregnancy may have increased preterm births among women in Montevideo, Uruguay. CITATION: Balsa AI, Caffera M, Bloomfield J. 2016. Exposures to particulate matter from the eruptions of the Puyehue Volcano and birth outcomes in Montevideo, Uruguay. Environ Health Perspect 124:1816-1822; http://dx.doi.org/10.1289/EHP235 [ABSTRACT FROM AUTHOR]

BACKGROUND: Ambient monitoring data show spatial gradients in ozone (O3) across urban areas. Nitrogen oxide (NOx) emissions reductions will likely alter these gradients. Epidemiological studies often use exposure surrogates that may not fully account for the impacts of spatially and temporally changing concentrations on population exposure. OBJECTIVES: We examined the impact of large NOx decreases on spatial and temporal O3 patterns and the implications on exposure. METHODS: We used a photochemical model to estimate O3 response to large NOx reductions. We derived time series of 2006-2008 O3 concentrations consistent with 50% and 75% NOx emissions reduction scenarios in three urban areas (Atlanta, Philadelphia, and Chicago) at each monitor location and spatially interpolated O3 to census-tract centroids. RESULTS: We predicted that low O3 concentrations would increase and high O3 concentrations would decrease in response to NOx reductions within an urban area. O3 increases occurred across larger areas for the seasonal mean metric than for the regulatory metric (annual 4th highest daily 8-hr maximum) and were located only in urban core areas. O3 always decreased outside the urban core (e.g., at locations of maximum local ozone concentration) for both metrics and decreased within the urban core in some instances. NOx reductions led to more uniform spatial gradients and diurnal and seasonal patterns and caused seasonal peaks in midrange O3 concentrations to shift from midsummer to earlier in the year. CONCLUSIONS: These changes have implications for how O3 exposure may change in response to NOx reductions and are informative for the design of future epidemiology studies and risk assessments. [ABSTRACT FROM AUTHOR]

Background: Limited information is available regarding long-term effects of air pollution on blood pressure (BP) and hypertension. Objective: We studied whether 1-year exposures to particulate matter (PM) and nitrogen oxides (NOx) were correlated with BP and hypertension in the elderly. Methods: We analyzed cross-sectional data from 27,752 Taipei City residents > 65 years of age who participated in a health examination program in 2009. Land-use regression models were used to estimate participants' 1-year exposures to particulate matter with aerodynamic diameter ≤ 10 μm (PM10), coarse particles (PM2.5-10), fine particles (≤ 2.5 μm; PM2.5), PM2.5 absorbance, NOx, and nitrogen dioxide (NO2). Generalized linear regressions and logistic regressions were used to examine the association between air pollution and BP and hypertension, respectively. Results: Diastolic BP was associated with 1-year exposures to air pollution, with estimates of 0.73 [95% confidence interval (CI): 0.44, 1.03], 0.46 (95% CI: 0.30, 0.63), 0.62 (95% CI: 0.24, 0.99), 0.34 (95% CI: 0.19, 0.50), and 0.65 (95% CI: 0.44, 0.85) mmHg for PM10 (10 μg/m3), PM2.5-10 (5 μg/m3), PM2.5 absorbance (10-5/m), NOx (20 μg/m3), and NO2 (10 μg/m3), respectively. PM2.5 was not associated with diastolic BP, and none of the air pollutants was associated with systolic BP. Associations of diastolic BP with PM10 and PM2.5 absorbance were stronger among participants with hypertension, diabetes, or a body mass index ≥ 25 kg/m2 than among participants without these conditions. One-year air pollution exposures were not associated with hypertension. Conclusions: One-year exposures to PM10, PM2.5-10, PM2.5 absorbance, and NOx were associated with higher diastolic BP in elderly residents of Taipei. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traffic-related air pollution has been associated with adverse health outcomes, and the immune system may be a biologic mediator of health effects. OBJECTIVES: We analyzed associations between living near major roads and immune status as measured by five immune assays. We hypothesized that living near a freeway, arterial, or truck route would be associated with increased inflammation and decreased immune function. METHODS: We used a geographic information system (GIS) to determine residential proximity to major roads among 115 postmenopausal, overweight women in the greater Seattle, Washington (USA), area whose immunity was assessed at the baseline visit of an exercise intervention trial. We evaluated three inflammatory markers (C-reactive protein, serum amyloid A, and interleukin-6) and two functional assays of cellular immunity [natural killer (NK) cell cytotoxicity and T-lymphocyte proliferation]. RESULTS: Women living within 150 m of arterial roads had 21% lower NK cytotoxicity compared with women who lived farther from an arterial [mean cytotoxicity, 19.5%; 95% confidence interval (CI), 15.6--23.5%; vs. mean cytotoxicity, 24.8%; 95% CI, 22.0--27.5%], after adjustment for both individual-level and census tract--level demographic characteristics. This association was limited to women who reported exercising near traffic. Fewer women lived near freeways and truck routes. Markers of inflammation and lymphocyte proliferation did not consistently differ according to proximity to major roads. CONCLUSIONS: If the observed association between residential proximity to traffic and decreased NK cytotoxicity is confirmed in other populations, our results may have implications for local land use policy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Air pollution data in Bangkok, Thailand, indicate that levels of particulate matter with aerodynamic diameter ≤ 10 µm (PM10) are significantly higher than in most cities in North America and Western Europe, where the health effects of PM10 are well documented. However, the pollution mix, seasonality, and demographics are different from those in developed Western countries. It is important, therefore, to determine whether the large metropolitan area of Bangkok is subject to similar effects of PM10. OBJECTIVES: This study was designed to investigate the mortality risk from air pollution in Bangkok, Thailand. METHODS: The study period extended from 1999 to 2003, for which the Ministry of Public Health provided the mortality data. Measures of air pollution were derived from air monitoring stations, and information on temperature and relative humidity was obtained from the weather station in central Bangkok. The statistical analysis followed the common protocol for the multicity PAPA (Public Health and Air Pollution Project in Asia) project in using a natural cubic spline model with smooths of time and weather. RESULTS: The excess risk for non-accidental mortality was 1.3% [95% confidence interval (CI), 0.8--1.7] per 10 µg/m3 of PM10, with higher excess risks for cardiovascular and above age 65 mortality of 1.9% (95% CI, 0.8--3.0) and 1.5% (95% CI, 0.9--2.1), respectively. In addition, the effects from PM10 appear to be consistent in multipollutant models. CONCLUSIONS: The results suggest strong associations between several different mortality outcomes and PM10. In many cases, the effect estimates were higher than those typically reported in Western industrialized nations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Various factors can modify the health effects of outdoor air pollution. Prior findings about modifiers are inconsistent, and most of these studies were conducted in developed countries. OBJECTIVES: We conducted a time-series analysis to examine the modifying effect of season, sex, age, and education on the association between outdoor air pollutants [particulate matter < 10 µm in aerodynamic diameter (PM10), sulfur dioxide, nitrogen dioxide, and ozone] and daily mortality in Shanghai, China, using 4 years of daily data (2001--2004). METHODS: Using a natural spline model to analyze the data, we examined effects of air pollution for the warm season (April--September) and cool season (October--March) separately. For total mortality, we examined the association stratified by sex and age. Stratified analysis by educational attainment was conducted for total, cardiovascular, and respiratory mortality. RESULTS: Outdoor air pollution was associated with mortality from all causes and from cardio-respiratory diseases in Shanghai. An increase of 10 µg/m3 in a 2-day average concentration of PM10, SO2, NO2, and O3 corresponds to increases in all-cause mortality of 0.25% [95% confidence interval (CI), 0.14--0.37), 0.95% (95% CI, 0.62--1.28), 0.97% (95% CI, 0.66--1.27), and 0.31% (95% CI, 0.04--0.58), respectively. The effects of air pollutants were more evident in the cool season than in the warm season, and females and the elderly were more vulnerable to outdoor air pollution. Effects of air pollution were generally greater in residents with low educational attainment (illiterate or primary school) compared with those with high educational attainment (middle school or above). CONCLUSIONS: Season, sex, age, and education may modify the health effects of outdoor air pollution in Shanghai. These findings provide new information about the effects of modifiers on the relationship between daily mortality and air pollution in developing countries and may have implications for local environmental and social policies. INSET: 4. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2003, residents of the District of Columbia (DC) experienced an abrupt rise in lead levels in drinking water, which followed a change in water-disinfection treatment in 2001 and which was attributed to consequent changes in water chemistry and corrosivity. OBJECTIVES: To evaluate the public health implications of the exceedance, the DC Department of Health expanded the scope of its monitoring programs for blood lead levels in children. METHODS: From 3 February 2004 to 31 July 2004, 6,834 DC residents were screened to determine their blood lead levels. RESULTS: Children from 6 months to 6 years of age constituted 2,342 of those tested; 65 had blood lead levels > 10 µg/dL (the "level of concern" defined by the Centers for Disease Control and Prevention), the highest with a level of 68 µg/dL. Investigation of their homes identified environmental sources of lead exposure other than tap water as the source, when the source was identified. Most of the children with elevated blood lead levels (n = 46; 70.8%) lived in homes without lead drinking-water service lines, which is the principal source of lead in drinking water in older cities. Although residents of houses with lead service lines had higher blood lead levels on average than those in houses that did not, this relationship is confounded. Older houses that retain lead service lines usually have not been rehabilitated and are more likely to be associated with other sources of exposure, particularly lead paint. None of 96 pregnant women tested showed blood lead levels > 10 µg/dL, but two nursing mothers had blood lead levels > 10 µg/dL. Among two data sets of 107 and 71 children for whom paired blood and water lead levels could be obtained, there was no correlation (r² = -0.03142 for the 107). CONCLUSIONS: The expanded screening program developed in response to increased lead levels in water uncovered the true dimensions of a continuing problem with sources of lead in homes, specifically lead paint. This study cannot be used to correlate lead in drinking water with blood lead levels directly because it is based on an ecologic rather than individualized exposure assessment; the protocol for measuring lead was based on regulatory requirements rather than estimating individual intake; numerous interventions were introduced to mitigate the effect; exposure from drinking water is confounded with other sources of lead in older houses; and the period of potential exposure was limited and variable. [ABSTRACT FROM AUTHOR]

BACKGROUND: Epidemiologic studies suggest that there may be an association between environmental exposure to persistent organic pollutants (POPs) and diabetes. OBJECTIVE: The aim of this study was to test the hypothesis that residential proximity to POP-contaminated waste sites result in increased rates of hospitalization for diabetes. METHODS: We determined the number of hospitalized patients 25-74 years of age diagnosed with diabetes in New York State exclusive of New York City for the years 1993-2000. Descriptive statistics and negative binomial regression were used to compare diabetes hospitalization rates in individuals who resided in ZIP codes containing or abutting hazardous waste sites containing POPs ("POP" sites); ZIP codes containing hazardous waste sites but with wastes other than POPs ("other" sites); and ZIP codes without any identified hazardous waste sites ("clean" sites). RESULTS: Compared with the hospitalization rates for diabetes in clean sites, the rate ratios for diabetes discharges for people residing in POP sites and "other" sites, after adjustment for potential confounders were 1.23 [95% confidence interval (CI), 1.15-1.32] and 1.25 (95% CI, 1.16-1.34), respectively. In a subset of POP sites along the Hudson River, where there is higher income, less smoking, better diet, and more exercise, the rate ratio was 1.36 (95% CI, 1.26-1.47) compared to clean sites. CONCLUSIONS: After controlling for major confounders, we found a statistically significant increase in the rate of hospitalization for diabetes among the population residing in the ZIP codes containing toxic waste sites. [ABSTRACT FROM AUTHOR]

The article provides news briefs pertaining to global environmental health. Beijing, China ensured the International Olympic Committee (IOC) that it would meet World Health Organization (WHO) air pollution standards by the commencement of the 2008 Olympic Summer Games; however, it is not yet known if the air will be clean enough for the games to begin as scheduled. At the June 2008 meeting of the American Society for Microbiology, researchers reported that global climate change is impacting Alaskan microbial communities. Research published in "Environmental Pollution" found that rice foods in Western supermarkets may have high levels of inorganic arsenic, implying high carcinogenic intake for babies fed rice.

The article reports that nitryl chloride has been detected by the National Oceanic and Atmospheric Administration (NOAA) in Galveston Bay, a shipping port near Houston, Texas. The ozone precursor was formed from ship exhaust plumes containing nitrogen oxides that produced a reaction between dinitrogen pentoxide and the chloride in sea mist. NOAA research chemist James Roberts comments on the need to control emissions from fossil fuel combustion in coastal areas to reduce air pollution.

The article reports on a study of air pollution that is associated with traffic congestion in New York City. Researchers Ying Zhou and Jonathan Levy of the Harvard School of Public Health focused on the dispersion of traffic emissions in streets that have tall buildings on both which are referred to as urban street canyons. The "intake fraction" for air pollutants from mobile sources was used to determine the type and amount of pollution that people are exposed to.