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PURE AIR: A global assessment of air pollution and cardiovascular disease

Funding: NIH Director’s Early Independence Awards. DP5ODO19850 (PI: Hystad)

Air pollution is linked to increased risks of mortality and cardiovascular and respiratory diseases; however, most studies of long-term air pollution exposure have been conducted in high-income countries with relatively low air pollution concentrations. In this project, we conducted the first global health study of air pollution using the large multi-national PURE cohort study, including individuals living in low and middle income countries with high air pollution levels.

We conducted an exposure assessment that integrated survey data, GIS and satellite models, and new air pollution monitoring. We collected air pollution measurements in 4,500 households and for 1,200 individuals living in 120 communities in eight countries to characterize air pollution exposure levels and drivers. Using clean fuels for cooking and heating substantially lowers kitchen PM2.5 concentrations. Importantly, average kitchen and personal PM2.5 measurements for all primary fuel types exceeded WHO's Interim Target-1 (35 μg/m3 annual average), highlighting the need for comprehensive air pollution mitigation strategies. The PURE-AIR monitoring database is orders of magnitude larger than previous monitoring studies and provides important new information on air pollution exposures and drivers in developing countries.

We observed associations between cooking with solid fuels, compared to clean fuels, and mortality as well as cardiovascular and respiratory disease. Overall, 6.6% of deaths and 6.9% of new cardiovascular cases could be attributed to household air pollution. 4.) We observed associations between outdoor fine particulate matter (PM2.5) air pollution and cardiovascular disease. We estimated that 13.9% of new cardiovascular cases could be attributed to ambient PM2.5 air pollution. Our study findings suggest that PM2.5 air pollution is an important global risk factor for cardiovascular disease.
We have ongoing research in the PURE study that is examining different air pollution exposures, and change in exposures over time, and diverse clinical measures (e.g. blood pressure, lung function) biomarkers, and health outcomes.

More information on the PURE-AIR research project can be found here: PURE-AIR

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Smoke Preparedness Planning and Interventions for Oregon’s Children

Funding: Environmental Protection Agency (EPA) (PIs: Kile and Hystad)

We are developing a set of interventions that includes tailored toolkits and resources that can be used by schools, preschools, and daycares to reduce wildfire smoke exposures and increase community resilience across Oregon. Testing and evaluation of our toolkit is occurring in partnership with SmokeWise Ashland.

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TRANSIT Accountability Study: Impact of Vehicle Emission Regulations on Traffic-Related Air Pollution Exposures and Infant Health

Funding: Health Effects institute (HEI), RFA 18-1 (PI: Hystad)

Introduction In the United States, billions of dollars have been spent implementing interventions to reduce traffic-related air pollution (TRAP). These interventions are usually regulatory actions focused on reducing tailpipe emissions. However, they also include local programs to reduce traffic congestion and excess vehicle emissions, such as electronic tolls and roadway capacity improvements. Few health studies have empirically evaluated the direct impact of air pollution exposure reductions from these emission regulations and congestion reduction programs; no studies have examined infant health, an important population health outcome linked to air pollution exposures.

We applied a research triangulation approach that leverage natural experiments and novel exposure science methods to determining how reductions in tailpipe air pollution emissions have affected adverse birth outcomes.

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Estimating Long-Term NO2 Exposures and Associated Asthma Incidence Burdens for the GBD 2022 Study and Beyond

Funding: Health Effects institute (HEI) (PI: Anenberg)

We developed a new global NO2 model to estimate global surface NO2 concentrations for use in the Global Burden of Disease study to estimate attributable pediatric asthma incidence.  The global spatial-temporal NO2 model (daily 50 m resolution from 2005 to 2020) has been integrated into over 20 epidemiological studies, burden of disease predictions, and policy analyses. Data and code are available in our resources page.

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Assessing Health Effects of Long-term Exposure to Low Levels of Ambient Air Pollution. Health Effects Institute

Funding: Health Effects institute (HEI) (PI: Brauer)

This study examined the impact of low levels of outdoor PM2.5 air pollution exposure on mortality for ~7 million individuals in Canada. A hybrid approach to estimating PM2.5 exposures frm 1981 to 2016 was conducted that integrated satellite data, air monitor sampling, and atmospheric modeling. Long-term outdoor PM2.5 exposures as low as 2.5 μg /m3 were associated with increased risk of death.

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Long-term Outdoor Air Pollution and Cause-Specific Mortality in a Pooled Analysis of 23 Asian Cohorts

Funding: Health Effects institute (HEI) (PI: Vermeulen)

This research examined the relationship between ambient PM2.5 and NO2 air pollution and all-cause and cause-specific mortality in Six cohorts from the Asia Cohort Consortium. Our global NO2 model was applied to estimate long-term exposure to traffic air pollution. For ambient NO2, combined results showed positive associations for all mortality outcomes, but large differences were observed across different cohorts.