title: Using spatio-temporal modeling for exposure assessment in an investigation of fine particulate air pollution and cardiovascular mortality.
abstract: BACKGROUND
  U.S. urban air quality has improved dramatically over the past decades. We evaluated acute effects of fine particulate matter (PM2.5) on cardiovascular (CVD) mortality among residents of Allegheny County in SW Pennsylvania (1999-2011) using spatio-temporal modeling of air pollutants (AP) to reduce misclassification error in exposure assessment.
  
  
  METHODS
  Spatio-temporal kriging of daily PM2.5and ozone (O3) was used to produce daily exposure estimates at the residence ZIP code. Time-stratified case-crossover analysis was conducted to examine short-term effects of PM2.5on CVD mortality, adjusting for O3and apparent mean temperature. We studied both single and distributed lags for days 0-5. All CVD mortality and subcategories of ischemic heart disease (IHD), acute myocardial infarction, cerebrovascular disease, peripheral vascular disease (PVD), heart failure and cardiac arrhythmia were examined.
  
  
  RESULTS
  A total of 62,135 deaths were identified. We found significant associations of PM2.5with IHD and PVD mortality at lag day 5: (2.1% (95% CI, 0.2-4.1%) and (7.6%, 95% CI, 0.05-15.7%) per 10µg/m3increase of PM2.5in single lag models and for IHD in distributed lag models. There were no statistically significant associations with PM2.5for any of the other outcomes.
  
  
  CONCLUSIONS
  The application of finer scale geographically resolved AP exposures made it possible to study acute effects of PM2.5on CVD mortality in a large metropolitan area. Our study results demonstrated the continued presence of a dose response relationship of increased risk of CVD mortality within this lower range of PM2.5exposure.
authors: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA 15261, USA.
authors: Arvind
authors: A
authors: Dabass
authors: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA 15261, USA. Electronic address: eot1@pitt.edu.
authors: Evelyn O
authors: EO
authors: Talbott
authors: University of Pittsburgh, School of Medicine, Department of Ophthalmology, 203 Lothrop Street, Pittsburgh, PA 15213, USA; University of Pittsburgh, Graduate School of Public Health, Department of Biostatistics, 130 DeSoto Street, Pittsburgh, PA 15261, USA.
authors: Richard A
authors: RA
authors: Bilonick
authors: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA 15261, USA.
authors: Judith R
authors: JR
authors: Rager
authors: Allegheny Health Network, Department of Emergency Medicine, 320 E North Avenue, Pittsburgh, PA 15212, USA.
authors: Arvind
authors: A
authors: Venkat
authors: University of Pittsburgh, Graduate School of Public Health, Department of Biostatistics, 130 DeSoto Street, Pittsburgh, PA 15261, USA.
authors: Gary M
authors: GM
authors: Marsh
authors: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 DeSoto Street, Pittsburgh, PA 15261, USA.
authors: Chunzhe
authors: C
authors: Duan
authors: University of Pittsburgh, Graduate School of Public Health, Environmental and Occupational Health, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, USA.
authors: Tao
authors: T
authors: Xue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D052638:Particulate Matter / Q000633:toxicity*; D010414:Pennsylvania / Q000453:epidemiology
chemical_list: D052638:Particulate Matter
keywords: Air pollution; Cardiovascular; Fine particulate matter; Health effects; PM(2.5)