Reproducibility of retrospective assessment of outdoor time-activity patterns as an individual determinant of long-term ambient ozone exposure

Ozone, Fine Particulate Matter, and Chronic Lower Respiratory Disease Mortality in the United States

RATIONALE

Short-term effects of air pollution exposure on respiratory disease mortality are well established. However, few studies have examined the effects of long-term exposure, and among those that have, results are inconsistent.

OBJECTIVES

To evaluate long-term association between ambient ozone, fine particulate matter (PM2.5, particles with an aerodynamic diameter of 2.5 μm or less), and chronic lower respiratory disease (CLRD) mortality in the contiguous United States.

METHODS

We fit Bayesian hierarchical spatial Poisson models, adjusting for five county-level covariates (percentage of adults aged ≥65 years, poverty, lifetime smoking, obesity, and temperature), with random effects at state and county levels to account for spatial heterogeneity and spatial dependence.

MEASUREMENTS AND MAIN RESULTS

We derived county-level average daily concentration levels for ambient ozone and PM2.5 for 2001-2008 from the U.S. Environmental Protection Agency's down-scaled estimates and obtained 2007-2008 CLRD deaths from the National Center for Health Statistics. Exposure to ambient ozone was associated with an increased rate of CLRD deaths, with a rate ratio of 1.05 (95% credible interval, 1.01-1.09) per 5-ppb increase in ozone; the association between ambient PM2.5 and CLRD mortality was positive but statistically insignificant (rate ratio, 1.07; 95% credible interval, 0.99-1.14).

CONCLUSIONS

This study links air pollution exposure data with CLRD mortality for all 3,109 contiguous U.S. counties. Ambient ozone may be associated with an increased rate of death from CLRD in the contiguous United States. Although we adjusted for selected county-level covariates and unobserved influences through Bayesian hierarchical spatial modeling, the possibility of ecologic bias remains.

Ozone-induced airway epithelial cell death, the neurokinin-1 receptor pathway, and the postnatal developing lung

Children are uniquely susceptible to ozone because airway and lung growth continue for an extensive period after birth. Early-life exposure of the rhesus monkey to repeated ozone cycles results in region-specific disrupted airway/lung growth, but the mediators and mechanisms are poorly understood. Substance P (SP), neurokinin-1 receptor (NK-1R); and nuclear receptor Nur77 (NR4A1) are signaling pathway components involved in ozone-induced cell death. We hypothesize that acute ozone (AO) exposure during postnatal airway development disrupts SP/NK-1R/Nur77 pathway expression and that these changes correlate with increased ozone-induced cell death. Our objectives were to 1) spatially define the normal development of the SP/NK-1R/Nur77 pathway in conducting airways; 2) compare how postnatal age modulates responses to AO exposure; and 3) determine how concomitant, episodic ozone exposure modifies age-specific acute responses. Male infant rhesus monkeys were assigned at age 1 mo to two age groups, 2 or 6 mo, and then to one of three exposure subgroups: filtered air (FA), FA+AO (AO: 8 h/day × 2 days), or episodic biweekly ozone exposure cycles (EAO: 8 h/day × 5 days/14-day cycle+AO). O3 = 0.5 ppm. We found that 1) ozone increases SP/NK-1R/Nur77 pathway expression in conducting airways, 2) an ozone exposure cycle (5 days/cycle) delivered early at age 2 mo resulted in an airway that was hypersensitive to AO exposure at the end of 2 mo, and 3) continued episodic exposure (11 cycles) resulted in an airway that was hyposensitive to AO exposure at 6 mo. These observations collectively associate with greater overall inflammation and epithelial cell death, particularly in early postnatal (2 mo), distal airways.

Agreement between contemporaneously recorded and subsequently recalled time spent outdoors: implications for environmental exposure studies

PURPOSE

The aim of the study is to evaluate the agreement between contemporaneously recorded and subsequently recalled time spent outdoors during 1 week among members of an occupational cohort.

METHODS

One hundred twenty-five radiologic technologists from northern and southern geographic areas in the United States recorded time spent outdoors for 7 consecutive days in a daily diary. Six months later, study participants completed a mailed self-administered questionnaire of the number of outdoor hours during the same 7-day period. We tested the agreement between questionnaire responses and diary entries. Logistic regression models were used to identify variables significantly affecting agreement.

RESULTS

Time spent outdoors comprised one fifth of the total time recorded in the diaries. Agreement (weighted kappa [kappa(w)]) between reported outdoor time during weekdays (kappa(w) = 0.49; 95% confidence interval [CI], 0.39-0.59) was significantly (p < 0.05) higher than for weekends (kappa(w) = 0.23; 95% CI, 0.12-0.34). Similarly, agreement was lower for weekends compared with weekdays in multivariate analyses, reaching statistical significance (p = 0.05) in only the southern regions.

CONCLUSIONS

Although our investigation was carried out among volunteers from the US radiologic technologist cohort, we believe retrospective questionnaires may be more accurate in reporting time spent outdoors for weekdays compared with weekends in any group of indoor workers. These differences have implications for the wording in future questionnaires about time spent outdoors and level and sources of uncertainty characterizing estimated time spent outdoors on weekdays versus weekend days.

Cytogenetic damage in buccal epithelia and peripheral lymphocytes of young healthy individuals exposed to ozone

Ozone (O(3)) is an important component of air pollution and a potent oxidant of biomolecules. To address the hypothesis that elevated ambient O(3) can induce cytogenetic damage in healthy people, we collected buccal cells from two groups of students (N = 126) from University of California, Berkeley, in the spring and again in the fall. One group spent their summer in the Los Angeles (LA) area where summer O(3) concentrations are significantly higher than in the San Francisco Bay (SF) area, and another remained in SF. During the school year, all students were exposed to low O(3) levels in SF. The micronucleus assay in a total of 611,000 buccal cells demonstrated that, in the fall, micronuclei (MN) in normal cells for the LA group had increased 39% relative to levels in the spring (1.52 and 0.87 MN/1,000 cells, respectively, P = 0.001). Students who spent the summer in SF had a 12.7% increase (P = 0.48). A similar effect of season was seen in degenerated buccal cells for the LA group (3.23 versus 1.88 MN/1,000 cells, P = 0.003). LA but not SF subjects also had more degenerated cells in the fall sample (P = 0.003). These findings were paralleled by an increase in MN and nucleoplasmic bridges in lymphocytes and MN in buccal cells in a sub-group of 15 students who underwent a 4-h controlled exposure to 200 p.p.b. O(3). This cytogenetic evidence, along with recent studies linking O(3) exposure to elevated lung cancer risk and mortality, suggest potential public health implications from exposures to high oxidant environments.