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Item Open Access The shape of the concentration–response association between fine particulate matter pollution and human mortality in Beijing, China, and its implications for health impact assessment(Colorado State University. Libraries, 2019-06-06) Yan, Meilin, author; Wilson, Ander, author; Bell, Michelle L., author; Peng, Roger D., author; Sun, Qinghua, author; Pu, Weiwei, author; Yin, Xiaomei, author; Li, Tiantian, author; Anderson, Brooke, author; Environmental Health Perspectives, publisherBackground: Studies found approximately linear short-term associations between particulate matter (PM) and mortality in Western communities. However, in China, where the urban PM levels are typically considerably higher than in Western communities, some studies suggest nonlinearity in this association. Health impact assessments (HIA) of PM in China have generally not incorporated nonlinearity in the concentration–response (C-R) association, which could result in large discrepancies in estimates of excess deaths if the true association is nonlinear. Objectives: We investigated nonlinearity in the C-R associations between with PM with aerodynamic diameter ≤2.5μm (PM2.5) and mortality in Beijing, China, and the sensitivity of HIA to linearity assumptions. Methods: We modeled the C-R association between PM2.5 and cause-specific mortality in Beijing, China (2009–2012), using generalized linear models (GLM). PM2.5 was included through either linear, piecewise-linear, or spline functions to investigate evidence of nonlinearity. To determine the sensitivity of HIA to linearity assumptions, we estimated PM2.5-attributable deaths using both linear- and nonlinear-based C-R associations between PM2.5 and mortality. Results: We found some evidence that, for nonaccidental and circulatory mortality, the shape of the C-R association was relatively flat at lower concentrations of PM2.5, but then had a positive slope at higher concentrations, indicating nonlinearity. Conversely, the shape for respiratory mortality was positive and linear at lower concentrations of PM2.5, but then leveled off at the higher concentrations. Estimates of excess deaths attributable to short-term PM2.5 exposure were, in some cases, very sensitive to the linearity assumption in the association, but in other cases robust to this assumption. Conclusions: Our results demonstrate some evidence of nonlinearity in PM2.5–mortality associations and that an assumption of linearity in this association can influence HIAs, highlighting the importance of understanding potential nonlinearity in the PM2.5–mortality association at the high concentrations of PM2.5 in developing megacities like Beijing. https://doi.org/10.1289/EHP4464Item Open Access Assessing United States county-level exposure for research on tropical cyclones and human health(Colorado State University. Libraries, 2020-10-28) Anderson, Brooke G., author; Ferreri, Joshua, author; Al-Hamdan, Mohammad, author; Crosson, William, author; Schumacher, Andrea, author; Guikema, Seth, author; Quiring, Steven, author; Eddelbuettel, Dirk, author; Yan, Meilin, author; Peng, Roger D., author; Environmental Health Perspectives, publisherBackground: Tropical cyclone epidemiology can be advanced through exposure assessment methods that are comprehensive and consistent across space and time, as these facilitate multiyear, multistorm studies. Further, an understanding of patterns in and between exposure metrics that are based on specific hazards of the storm can help in designing tropical cyclone epidemiological research. Objectives: a) Provide an open-source data set for tropical cyclone exposure assessment for epidemiological research; and b) investigate patterns and agreement between county-level assessments of tropical cyclone exposure based on different storm hazards. Methods: We created an open-source data set with data at the county level on exposure to four tropical cyclone hazards: peak sustained wind, rainfall, flooding, and tornadoes. The data cover all eastern U.S. counties for all land-falling or near-land Atlantic basin storms, covering 1996–2011 for all metrics and up to 1988–2018 for specific metrics. We validated measurements against other data sources and investigated patterns and agreement among binary exposure classifications based on these metrics, as well as compared them to use of distance from the storm’s track, which has been used as a proxy for exposure in some epidemiological studies. Results: Our open-source data set was typically consistent with data from other sources, and we present and discuss areas of disagreement and other caveats. Over the study period and area, tropical cyclones typically brought different hazards to different counties. Therefore, when comparing exposure assessment between different hazard-specific metrics, agreement was usually low, as it also was when comparing exposure assessment based on a distance-based proxy measurement and any of the hazard-specific metrics. Discussion: Our results provide a multihazard data set that can be leveraged for epidemiological research on tropical cyclones, as well as insights that can inform the design and analysis for tropical cyclone epidemiological research.Item Open Access Quantifying proximity, confinement, and interventions in disease outbreaks: a decision support framework for air-transported pathogens(Colorado State University. Libraries, 2021-02-19) Bond, Tami C, author; Bosco-Lauth, Angela, author; Farmer, Delphine K., author; Francisco, Paul W., author; Pierce, Jeffrey R., author; Fedak, Kristen M., author; Ham, Jay M., author; Jathar, Shantanu H., author; VandeWoude, Sue, author; Environmental Science & Technology, publisherThe inability to communicate how infectious diseases are transmitted in human environments has triggered avoidance of interactions during the COVID-19 pandemic. We define a metric, Effective ReBreathed Volume (ERBV), that encapsulates how infectious pathogens, including SARS-CoV-2, transport in air. ERBV separates environmental transport from other factors in the chain of infection, allowing quantitative comparisons among situations. Particle size affects transport, removal onto surfaces, and elimination by mitigation measures, so ERBV is presented for a range of exhaled particle diameters: 1, 10, and 100 μm. Pathogen transport depends on both proximity and confinement. If interpersonal distancing of 2 m is maintained, then confinement, not proximity, dominates rebreathing after 10–15 min in enclosed spaces for all but 100 μm particles. We analyze strategies to reduce this confinement effect. Ventilation and filtration reduce person-to-person transport of 1 μm particles (ERBV1) by 13–85% in residential and office situations. Deposition to surfaces competes with intentional removal for 10 and 100 μm particles, so the same interventions reduce ERBV10 by only 3–50%, and ERBV100 is unaffected. Prior knowledge of size-dependent ERBV would help identify transmission modes and effective interventions. This framework supports mitigation decisions in emerging situations, even before other infectious parameters are known.Item Open Access Health impact assessment of coal-fired boiler retirement at the Martin Drake and Comanche power plants(Colorado State University. Libraries, 2018-09-07) Martenies, Sheena, author; Gan, Ryan, author; Magzamen, Sheryl, author; Akherati, Ali, author; Jathar, Shantanu, authorHealth impact assessment (HIA) is a suite of tools used to characterize potential health effects of policies, projects, or regulations. The objective of this HIA was to understand the impact of decommissioning units at two large coal-fired power plants on mortality and morbidity in the Southern Front Range region of Colorado. Based on Community Multiscale Air Quality (CMAQ) chemical transport models of fine particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and ozone (O3), we modeled five potential emissions reductions scenarios and estimated the potential health benefits of reduced exposures to PM2.5 and ozone for premature deaths, cardiovascular and respiratory hospitalizations, and other health outcomes for ZIP codes in the Southern Front Range region, including the cities of Denver, Colorado Springs, and Pueblo. Health Benefits Scenarios 1 and 2 estimated the health benefits of shutting down most units at the Comanche plant in Pueblo, CO (one newer unit remained operational) relative to a baseline scenario using emissions from 2011 (Scenario 1) or a counterfactual baseline scenario that accounted for sulfur dioxide emissions controls (scrubbers) installed at the Martin Drake plant in Colorado Springs in 2016 (Scenario 2). Health Benefits Scenario 3 estimated the benefits of shutting down the Martin Drake plant relative to the 2011 baseline. Health Benefits Scenario 4 estimated the health benefits of shutting down the Martin Drake power plant and shutting down all but one boiler at the Comanche power plant relative to a 2011 emissions baseline. Health Benefits Scenario 5 estimated the marginal health benefits of decommissioning these plants (with one remaining coal-fired boiler at Comanche) relative to a counterfactual baseline year that considered emissions controls installed at the Martin Drake facility in 2016. In addition to estimating the number of deaths, hospitalizations, and other health outcomes that would potentially be avoided by reducing emissions at these facilities, we also estimated the monetary impact using outcome valuations typically used in US EPA health benefits analyses and examined the environmental justice implications of reduced emissions and exposures across the Southern Front Range. • For Health Benefits Scenario 1 (Comanche Units 3 and 4 were “zeroed out” and compared to a baseline where all other emissions were at 2011 levels), we estimated that reducing population exposures to PM2.5 would result in 1 (95% CI: 0 - 1) fewer premature death each year. Reductions in PM2.5 and O3 exposures would also result in fewer restricted activity days among adults [5 (95% CI: -3 – 95)] and fewer missed school days for children [27 (95% CI: -19- 582)]. Benefits of retiring the Comanche units were similar when emissions controls at Martin Drake are taken into account (Health Benefits Scenario 2). • For Health Benefits Scenario 3 (emissions at Martin Drake were “zeroed out”), we estimated that reducing population exposures to PM2.5 and O3 would result in 4 (95% CI: 2 - 5) and < 1 (95% CI: 0 - 1) fewer premature deaths each year, respectively. Reductions in PM2.5 and O3 exposures would also result in fewer restricted activity days among adults [10 (95% CI: 0 – 74)] and fewer missed school days for children [4 (95% CI: 2- 5)]. • For Health Benefits Scenario 4, we estimated that reducing population exposures to PM2.5 and O3 would result in 4 (95% CI: 2 - 6) and < 1 (95% CI: 0 - 1) fewer premature deaths each year, respectively. Among the largest annual health benefits are avoided asthma symptom days among children [16 (95% CI: -1 – 141) due to PM2.5 and 13 (95% CI: -348 - 972) due to O3] and minor restricted activity days among adults [69 (95% CI: 0 - 488) due to PM2.5 and 71 (95% CI: -31 - 750) due to O3]. We also estimated that, for Health Benefits Scenario 1, children in the study area would miss 77 (95% CI: -77 - 1180) fewer days of school each year due to lower O3 exposures. • Annual health benefits were lower for Health Benefits Scenario 5 compared to Scenario 4 due to the smaller change in exposure concentration after accounting for the control technologies installed at Martin Drake in 2016. For Health Benefits Scenario 5, we estimated that reducing population exposures to PM2.5 and O3 would result in 2 (95% CI: 1 - 3) and < 1 (95% CI: 0 - 1) fewer premature deaths each year, respectively. Other annual benefits under Health Benefits Scenario 2 included 2 (95% CI: -17 – 44) and 9 (-242 – 678) avoided asthma symptom days due to PM2.5 and O3 exposures, respectively; 28 (95%CI: -2 – 188) and 48 (95%CI: -16 – 513) minor restricted activity days due to PM2.5 and O3 exposures; and 53 (95% CI: -48 – 833) avoided school absences among children due to O3 exposures. • Monetized health benefits when both plants were “zeroed out” ranged from $4.2 million (95% CI: $2.1 million - $7.2 million) for Health Benefits Scenario 4 to $1.7 million (95% CI: $0.8 million – 3.2 million) for Health Benefits Scenario 5. Benefits tended to be smaller when only one plant was considered. In all of the analyses, the monetized impacts were driven by the value of avoided premature mortality. In addition, we found that ZIP codes with lower median incomes tended to receive a greater share of the health benefits of decreasing exposures to PM2.5 and O3 resulting from power plant shutdowns. This finding suggests that reducing emissions at the power plants could potentially alleviate some environmental justice concerns in the area.Item Open Access Effects of 28Si ions, 56Fe ions, and protons on the induction of murine acute myeloid leukemia and hepatocellular carcinoma(Colorado State University. Libraries, 2014-08) Weil, Michael M., author; Ullrich, Robert L., author; Fallgren, Christina M., author; McCarthy, Maureen, author; Yu, Yongjia, author; Genik, Paula C., author; Ray, F. Andrew, author; Public Library of Science, publisherEstimates of cancer risks posed to space-flight crews by exposure to high atomic number, high-energy (HZE) ions are subject to considerable uncertainty because epidemiological data do not exist for human populations exposed to similar radiation qualities. We assessed the carcinogenic effects of 300 MeV/n 28Si or 600 MeV/n 56Fe ions in a mouse model for radiation-induced acute myeloid leukemia and hepatocellular carcinoma. C3H/HeNCrl mice were irradiated with 0.1, 0.2, 0.4, or 1 Gy of 300 MeV/n 28Si ions, 600 MeV/n 56Fe ions or 1 or 2 Gy of protons simulating the 1972 solar particle event (1972SPE) at the NASA Space Radiation Laboratory. Additional mice were irradiated with 137Cs gamma rays at doses of 1, 2, or 3 Gy. All groups were followed until they were moribund or reached 800 days of age. We found that 28Si or 56Fe ions do not appear to be substantially more effective than gamma rays for the induction of acute myeloid leukemia. However, 28Si or 56Fe ion irradiated mice had a much higher incidence of hepatocellular carcinoma than gamma ray irradiated or proton irradiated mice. These data demonstrate a clear difference in the effects of these HZE ions on the induction of leukemia compared to solid tumors, suggesting potentially different mechanisms of tumorigenesis. Also seen in this study was an increase in metastatic hepatocellular carcinoma in the 28Si and 56Fe ion irradiated mice compared with those exposed to gamma rays or 1972SPE protons, a finding with important implications for setting radiation exposure limits for space-flight crew members.