Professional Documents
Culture Documents
Rupa Basu, PhD, MPH, Research Scientist Air Pollution Epidemiology Section/OEHHA California EPA June 25, 2012
Introduction
California Energy Commission climate change studies AB 32 & SB 375: for climate change research and reducing greenhouse gases from passenger vehicles by 2020 and 2050 to 1990 levels SB25 to focus research on infants and children IPCC report (2007): need to focus research on identifying vulnerable populations from effects of temperature
1) Shift in blood circulation 2) Stress on heart 3) High sweating threshold 4) Elevated cholesterol 5) Decreased uterine blood flow, increased oxytocin
Questions to Address
1. What is the effect of temperature on mortality in California? 2. Are the effects of temperature independent of those from air pollution? 3. Can we identify subgroups that are particularly susceptible? 4. What were the full effects of the 2006 heat wave? How high are the effects/degree? 5. Do we observe effects of temperature on hospital admissions and emergency room visits? 6. Are any there any temperature effects affecting adverse birth outcomes, such as preterm delivery?
Study Objectives
To assess the association of apparent temperature on deaths, hospital admissions, ER visits, and preterm delivery in California Limited analyses to May 1-September 30 To determine how the associations differ by causespecific outcomes, race, age, education level, gender To determine how the mortality association changes during a heat wave (CA 2006 heat wave)
Mean Daily Apparent Temperature (F) for Nine California Counties, May-September 1999-2003
Data
Daily apparent temperature (EPA AIRS database and California Irrigation Management Information System) Incorporates temperature and relative humidity Outcomes of interest (CA Dept of Public Health) Daily all-cause death (1999-2003) Daily all-cause hospital admissions (1999-2005) Premature births (1999-2006) Air pollutants (CA Air Resources Board) PM2.5, O3, CO, NO2
Data Analysis
Two epidemiologic methods commonly used for studies of air pollution and temperature Separate analyses by monitor/county County estimates combined in metaanalysis
Monitor within 10 km of residential zip code centroid, then combined by climate zone (California Energy Commission)
CASE: Case period R1-R10: Referent periods 1-10 every third day in the same month and year T0: Time that case occurred (death date) T-24T+18: Time that referent periods occurred
Basu and Ostro (2008)
Results
Apparent Temperature Per 10oF and All-cause Mortality for Various Lags Times
HEAT WAVE
Estimates remained relatively unchanged after adjusting for air pollutants Risks often varied by age or racial/ethnic group
Study Population
Birth between 20-36 gestational weeks Limited to residential zip codes within 10 kilometers of a temperature/pollution monitor Inclusion: singleton births with at least 20 births per county for variables of interest Exclusion: deliveries induced because of pregnancy complications n~60,000 births throughout 16 counties
Percent change for preterm delivery per 10F increase in weekly average apparent temperature by maternal age category
Percent change for preterm delivery per 10F increase in weekly average apparent temperature by maternal race/ethnicity
On-going Research
Further studies of temperature and adverse birth outcomes Collaboration with Kaiser Division of Research to examine temperature and preterm delivery Collaboration with Scripps to examine heat waves and health effects