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Temperature, Air Pollution, and Mortality in the NIH-AARP Cohort.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Temperature, Air Pollution, and Mortality in the NIH-AARP Cohort./
Author:	Lim, Chris Chaeha.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	162 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-09, Section: B.
Contained By:	Dissertations Abstracts International80-09B.
Subject:	Environmental Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13421492
ISBN:	9781392004661

Temperature, Air Pollution, and Mortality in the NIH-AARP Cohort.
Lim, Chris Chaeha.

Temperature, Air Pollution, and Mortality in the NIH-AARP Cohort. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 162 p.

Source: Dissertations Abstracts International, Volume: 80-09, Section: B.

Thesis (Ph.D.)--New York University, 2019.

This item is not available from ProQuest Dissertations & Theses.

Climate change is projected to alter long-term temperature averages and patterns on a global scale. While numerous studies have examined acute effects of temperature on mortality risk, potential effects of long-term temperature exposure on cause-specific mortality risk have not been previously evaluated in a prospective cohort study. The overall aim of this dissertation is to assess the associations of long-term exposure to seasonal temperature average and variability with annual cause-specific mortality risk in a well-characterized prospective cohort. The dataset analyzed is the NIH-AARP Diet and Health Study cohort, which includes more than half million participants across 6 states and 2 cities in the United States and with a follow-up period of 17 years. The cohort contains detailed information on both individual- and contextual-level covariates and multiple causes of death, enabling a more definitive evaluation of the association between changes in long-term temperature and mortality than possible in past works. Chapter 1 provides a detailed overview of the current literature and rationale for this dissertation. I summarize various aspects of the relationship between short-term temperature exposure and human health, including thermoregulation, effects of heat/cold variations and extremes, and interaction effects with air pollution; and the available literature on potential health effects of long-term temperature exposure. Normally, the core body temperature is tightly regulated within a narrow range around 37°C as the body is thermally balanced by dynamic heat loss and heat gain to minimize heat exchange with its surrounding environments and to maintain the core body temperature relatively constant. However, when temperatures become variable or extreme, adverse physiological and cardiorespiratory changes occur and increase the mortality risks, which I seek to quantify in this cohort. This is considered in the context of past/current adaptations and future projections for this relationship, especially in relation to climate change and its potential impacts on changing temperature patterns and variability. Chapter 2 provides a summary description of the various environmental exposure metrics that were processed and linked to the cohort. For this dissertation, multiple large datasets from various sources were procured, cleaned, and analyzed: fine particulate matter, nitrogen dioxide, ozone, temperature, and NDVI. Descriptive statistics, correlations, and temporal trends are also visualized and presented. Annual PM2.5 and NO2 levels decreased substantially over the study period, while O3 levels remained relatively constant. Strong positive correlations were also observed between PM2.5 and NO2. Chapter 3 links summer and winter temperature average and temperature variability, defined here as the standard deviation of both daily minimum and maximum temperatures within the seasons, for each participant as time-varying exposures at the residence census-tract level. Using the extended Cox proportional hazards, I find significantly elevated mortality risks associated with increases in summer TA and winter TV. Increase in winter TA was significantly associated with increased ischemic heart disease mortality risk and decreased respiratory disease mortality risk. Vulnerable subpopulations are identified, including those with higher education levels and those with lower BMI levels, and potential mechanisms are discussed. These findings suggest that prolonged exposure to elevated temperature and temperature variability is significantly associated with annual cause-specific mortality risk. Climate change, which will shift long-term temperature patterns, is shown to be major threat to public health. Chapter 4 presents evaluations of the associations between long-term exposure to O3 and cause-specific mortality risk within the same cohort, finding that O3 significantly elevates cardiovascular disease, ischemic heart disease, respiratory disease, and COPD mortality risks. No susceptible subpopulations are observed. I also analyze the effects of considering other air pollutants within a multi-pollutant framework, and the ozone-mortality effect estimates remain similar. In addition, I evaluate the potential effects of considering temperature in the ozone-mortality models, with results indicating that that the O3-mortality associations are both modified and confounded by temperature, suggesting an inability to statistically separate their respective mortality associations. Finally, chapter 5 summarizes the past chapters and provides in-depth discussion and implications of the dissertation research. This dissertation provides novel evidence that changes in long-term temperature averages and patterns can have a significant effect on several causes of deaths, indicating that the mortality effects of climate change will be larger than previously estimated. Long-term temperature exposure will have a life-shortening impact that is significantly greater than the effects of short-term temperature exposures. Furthermore, the findings of significant associations between long-term ozone exposure and mortality risk, and effect modification of these relationships by temperature, imply that increases in ozone levels associated with climate change will also have a substantial and previously underappreciated impact on public health. (Abstract shortened by ProQuest.).

ISBN: 9781392004661Subjects--Topical Terms:

578282
Environmental Health.
Subjects--Index Terms:

Climate change

Temperature, Air Pollution, and Mortality in the NIH-AARP Cohort.
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The cohort contains detailed information on both individual- and contextual-level covariates and multiple causes of death, enabling a more definitive evaluation of the association between changes in long-term temperature and mortality than possible in past works. Chapter 1 provides a detailed overview of the current literature and rationale for this dissertation. I summarize various aspects of the relationship between short-term temperature exposure and human health, including thermoregulation, effects of heat/cold variations and extremes, and interaction effects with air pollution; and the available literature on potential health effects of long-term temperature exposure. Normally, the core body temperature is tightly regulated within a narrow range around 37°C as the body is thermally balanced by dynamic heat loss and heat gain to minimize heat exchange with its surrounding environments and to maintain the core body temperature relatively constant. However, when temperatures become variable or extreme, adverse physiological and cardiorespiratory changes occur and increase the mortality risks, which I seek to quantify in this cohort. This is considered in the context of past/current adaptations and future projections for this relationship, especially in relation to climate change and its potential impacts on changing temperature patterns and variability. Chapter 2 provides a summary description of the various environmental exposure metrics that were processed and linked to the cohort. For this dissertation, multiple large datasets from various sources were procured, cleaned, and analyzed: fine particulate matter, nitrogen dioxide, ozone, temperature, and NDVI. Descriptive statistics, correlations, and temporal trends are also visualized and presented. Annual PM2.5 and NO2 levels decreased substantially over the study period, while O3 levels remained relatively constant. Strong positive correlations were also observed between PM2.5 and NO2. Chapter 3 links summer and winter temperature average and temperature variability, defined here as the standard deviation of both daily minimum and maximum temperatures within the seasons, for each participant as time-varying exposures at the residence census-tract level. Using the extended Cox proportional hazards, I find significantly elevated mortality risks associated with increases in summer TA and winter TV. Increase in winter TA was significantly associated with increased ischemic heart disease mortality risk and decreased respiratory disease mortality risk. Vulnerable subpopulations are identified, including those with higher education levels and those with lower BMI levels, and potential mechanisms are discussed. These findings suggest that prolonged exposure to elevated temperature and temperature variability is significantly associated with annual cause-specific mortality risk. Climate change, which will shift long-term temperature patterns, is shown to be major threat to public health. Chapter 4 presents evaluations of the associations between long-term exposure to O3 and cause-specific mortality risk within the same cohort, finding that O3 significantly elevates cardiovascular disease, ischemic heart disease, respiratory disease, and COPD mortality risks. No susceptible subpopulations are observed. I also analyze the effects of considering other air pollutants within a multi-pollutant framework, and the ozone-mortality effect estimates remain similar. In addition, I evaluate the potential effects of considering temperature in the ozone-mortality models, with results indicating that that the O3-mortality associations are both modified and confounded by temperature, suggesting an inability to statistically separate their respective mortality associations. Finally, chapter 5 summarizes the past chapters and provides in-depth discussion and implications of the dissertation research. This dissertation provides novel evidence that changes in long-term temperature averages and patterns can have a significant effect on several causes of deaths, indicating that the mortality effects of climate change will be larger than previously estimated. Long-term temperature exposure will have a life-shortening impact that is significantly greater than the effects of short-term temperature exposures. Furthermore, the findings of significant associations between long-term ozone exposure and mortality risk, and effect modification of these relationships by temperature, imply that increases in ozone levels associated with climate change will also have a substantial and previously underappreciated impact on public health. (Abstract shortened by ProQuest.).
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