title: Particulate air pollution and chronic ischemic heart disease in the eastern United States: a county level ecological study using satellite aerosol data.
abstract: BACKGROUND
  There are several known factors that cause ischemic heart disease. However, the part played by air pollution still remains something of a mystery. Recent attention has focused on the chronic effect of particulate matter on heart disease. Satellite-derived aerosol optical depth (AOD) was found to be correlated with PM2.5 in the eastern US. The objective of this study was to examine if there is an association between aerosol air pollution as indicated by AOD and chronic ischemic heart disease (CIHD) in the eastern US.
  
  
  METHODS
  An ecological geographic study method was employed. Race and age standardized mortality rate (SMR) of CIHD was computed for each of the 2306 counties for the time period 2003-2004. A mean AOD raster grid for the same period was derived from Moderate Resolution Imaging Spectrometer (MODIS) aerosol data and the average AOD was calculated for each county. A bivariate Moran's I scatter plot, a map of local indicator of spatial association (LISA) clusters, and three regression models (ordinary least square, spatial lag, and spatial error) were used to analyze the relationship between AOD and CIHD SMR.
  
  
  RESULTS
  The global Moran's I value is 0.2673 (p = 0.001), indicating an overall positive spatial correlation of CIHD SMR and AOD. The entire study area is dominated by spatial clusters of AOD against SMR (high AOD and high SMR in the east, and low AOD and low SMR in the west) (permutations = 999, p = 0.05). Of the three regression models, the spatial error model achieved the best fit (R2 = 0.28). The effect of AOD is positive and significant (beta = 0.7774, p = 0.01).
  
  
  CONCLUSIONS
  Aerosol particle pollution has adverse effect on CIHD mortality risk in the eastern US. High risk of CIHD mortality was found in areas with elevated levels of outdoor aerosol air pollution as indicated by satellite derived AOD. The evidence of the association would support targeting of policy interventions on such areas to reduce air pollution levels. Remote sensing AOD data could be used as an alternative health-related indictor of air quality.
authors.affiliation: Department of Environmental Studies, University of West Florida, Pensacola, Florida, USA. zhu@uwf.edu
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Hu
authors.forename: K Ranga
authors.initials: KR
authors.lastname: Rao
mesh_terms: D000336:Aerosols; D000393:Air Pollutants / Q000032:analysis*; D002908:Chronic Disease; D005843:Geography; D006801:Humans; D017202:Myocardial Ischemia / Q000401:mortality*; D052638:Particulate Matter / Q000032:analysis*; D012044:Regression Analysis; D018531:Spacecraft; D014481:United States / Q000453:epidemiology
chemical_list: D000336:Aerosols; D000393:Air Pollutants; D052638:Particulate Matter