The Health Impacts of Air

Transcription

1 The Health Impacts of Air Pollution and Climate Change: Integration ti of Heterogeneous Data Francesca Dominici i i Harvard School of Public Health January

2 Scientific Investigations Health effects of air pollution Mortality risks associated with heat waves Climate change, heat waves, and mortality in the next century

3 National Data Bases (Total size approx 10 TB) Other supplemental data 1.5TB Air Pollution (EPA) 500 GB Health data (Medicare) 3 TB Weather data (NOAA) 42 GB Heterogeneous data bases linked by time and space

4 Table 1 Datasets include environmental health information Data set Source Time Period Data Size Census (zipcode US Census 1990, 2000, 307 level) Bureau and 2010 million (20GB) Weather NOAA (monitor level [n=5000, hourly) million (42 GB) Air pollution EPA million (monitor (300 GB) level [n=5000 hourly and daily) Key Information Demographics and socioeconomic status Daily temperature, dew point, sea level pressure, visibility, and wind speed Daily ambient pollution concentrations for criteria pollutants (e.g., PM10, PM2.5, O3, NO2, CO) for available counties throughout h US. PM mass concentration data are available as 24 hour integrated samples, usually daily, but sometimes on a 1 in 3 or 1 in 6 day sampling schedule.

5 Table 2 Datasets include health outcome information Data set Source Time Period Data Size Key Information Medicare enrollment (atthe beneficiarylevel, CMS %, 42 million Age, sex, race, Medicare per year (120 GB) plan, zipcode, mortality, zip code of state by in, dual eligible residence) Medicare Part A inpatient CMS %, 14 million Age, sex, race, diagnosis and per year (200 GB) procedure codes, payments, admission and discharge dates, charges, discharge dispositions physicians specialties, mortality, zipcode Medicare carrier/physician/sup CMS % of Medicare Age, sex, race, diagnosis and enrollment data procedure codes, dates of plierpart B (patient (20 GB) physician office visits, level) charges, physician specialties

6 Data Center Per 100,000 person year

7 Data Challenges Size Security Data use agreement Access to High Performance Computing Cost of the data Data storage and back up Statistical i Methods and Computation 1/29/ Medicare data: opportunities and challenges

8 The National Medicare Cohort Study, (MCAPS) Medicare data include: Billing claims for everyone over 65 enrolled in Medicare (~48 million people), date of service disease (ICD 9) age, gender, and race place of residence (zip code) Approximately 204 counties linked to the PM 2.5 monitoring network

9 MCAPS study population: 204 counties with populations larger than 200, (11.5 million people)

10 Daily time series of hospitalization rates and PM 2.5 levels in Los Angeles county ( )

11 PM 2.5 and Admissions PM and Admissions Dominici et al JAMA 2006 Peng et al JAMA 2008 US EPA PM Fact Sheet 2006: To better protect public health EPA issued the Agency most protective suite of national air quality standards for particle pollution ever

12 O 3 Mortality November

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14 Mortality in the Medicare Population and Chronic Exposure to PM 2.5 in 4568 zip codes in the US ( ) 2.5 p ( ) Map of spatially smoothed averages of PM 2.5 during the study period. The maps also indicates the zip codes centroid locations and the three regions of the United States: Western, Central and Eastern Zeger et al EHP 2009

15 LE in 2007 in 545 US counties A reduction of 1.6 units in PM2.5 from 2000 to 2007 was associated with a gain in LE of approx 1/3 of the year g / m 3 Correia et al Epidemiology 2013

16 New Scientific Questions and Statistical Challenges What are the mechanisms of PM toxicity? Size? Chemical components? Sources?

17 PM 2.5 chemical components on mortality rates:

18 Climate Change Heat Waves Health

19 A National Study of Heat Waves and Mortality Log Relative Risks of Mortality Associated with a Heat Wave Day: Results are shown for the largest 105 cities using data for the period 1987 to Results are grouped by geographical region and within each group are plotted as a function of the longitude (south to north) Bobb JF, Dominici F, Peng R (2011) A Bayesian Model Averaging Approach for Estimating the Relative Risk of Mortality Associated with Heat Waves in 105 U.S. Cities, Biometrics, 67(4):

20 Analysis Schematic and Data Integration (Chicago, ) (Chicago, )

21 Annual excess mortality attributable to heat waves in Chicago, , for seven climate models under the B1, A1B, and A2 SRES scenarios (with 95% confidence intervals) Projected increases of the population 2,217 in industrialized excess countries deaths x 57% year 20% 21% Peng et al EHP 2011

22 GCM Models Atmospheric Chemistry Statistical Models Downscaling Temperature PM 2.5 Ozone Forest Fires Exposure Response Joint effects Adaptation Susceptibility

23 Concluding remarks Data on health, environmental stressors are available but are collected for different purposes The linkage of these large and heterogeneous sources and the development of statistical methods has allowed us to address several important t questions However, moving forward, we will need support from both the university and government agencies that will allow us to specifically maintain these data centers

24 Computers p don t need to look out the window. The don t need to be close to their colleagues. They need to be close to each other, which is what we re doing with this computing space James Cuff, Director of Research Computing at Harvard and Chief Technology Architect

25 Funding (thanks!) R01 ES (Dominici) (NIEHS) R01 ES (Peng) (NIH) RD (Koutrakis) (EPA) R21 ES (Peng) (NIEHS) HEI (Dominici, Zigler) RD R (Dominici) (EPA)