Benzene and NO2 Exposure during Pregnancy and Preterm Birth in Two Philadelphia Hospitals, 2013-2017.

Infants born preterm are at risk of neonatal morbidity and mortality. Preterm birth (PTB) can be categorized as either spontaneous (sPTB) or medically indicated (mPTB), resulting from distinct pathophysiologic processes such as preterm labor or preeclampsia, respectively. A growing body of literature has demonstrated the impacts of nitrogen dioxide (NO2) and benzene exposure on PTB, though few studies have investigated how these associations may differ by PTB subtype. We investigated the associations of NO2 and benzene exposure with sPTB and mPTB among 18,616 singleton live births at two Philadelphia hospitals between 2013 and 2017. Residential NO2 exposure was estimated using a land use regression model and averaged over the patient's full pregnancy. Benzene exposure was estimated at the census tract level using National Air Toxics Assessment (NATA) exposure data from 2014. We used logistic mixed-effects models to calculate odds ratios for overall PTB, sPTB, and mPTB separately, adjusting for patient- and tract-level confounders. Given the known racial segregation and PTB disparities in Philadelphia, we also examined race-stratified models. Counter to the hypothesis, neither NO2 nor benzene exposure differed by race, and neither were significantly associated with PTB or PTB subtypes. As such, these pollutants do not appear to explain the racial disparities in PTB in this setting.

Long-Term Ambient Air Pollution Exposures and Circulating and Stimulated Inflammatory Mediators in a Cohort of Midlife Adults.

BACKGROUND: Chronic exposure to air pollution may prime the immune system to be reactive, increasing inflammatory responses to immune stimulation and providing a pathway to increased risk for inflammatory diseases, including asthma and cardiovascular disease. Although long-term exposure to ambient air pollution has been associated with increased circulating markers of inflammation, it is unknown whether it also relates to the magnitude of inflammatory response. OBJECTIVES: The aim of this study was to examine associations between chronic ambient pollution exposures and circulating and stimulated levels of inflammatory mediators in a cohort of healthy adults. METHODS: Circulating interleukin (IL)-6, C-reactive protein (CRP) (n=392), and lipopolysaccharide stimulated production of IL-1ß, IL-6, and tumor necrosis factor (TNF)-α (n=379) were measured in the Adult Health and Behavior II cohort. Fine particulate matter [particulate matter with aerodynamic diameter less than or equal to 2.5 µm (PM2.5)] and constituents [black carbon (BC), and lead (Pb), manganese (Mn), zinc (Zn), and iron (Fe)] were estimated for each residential address using hybrid dispersion land use regression models. Associations between pollutant exposures and inflammatory measures were examined using linear regression; models were adjusted for age, sex, race, education, smoking, body mass index, and month of blood draw. RESULTS: There were no significant correlations between circulating and stimulated measures of inflammation. Significant positive associations were found between exposure to PM2.5 and BC with stimulated production of IL-6, IL-1ß, and TNF-α. Pb, Mn, Fe, and Zn exposures were positively associated with stimulated production of IL-1ß and TNF-α. No pollutants were associated with circulating IL-6 or CRP levels. DISCUSSION: Exposure to PM2.5, BC, Pb, Mn, Fe, and Zn was associated with increased production of inflammatory mediators by stimulated immune cells. In contrast, pollutant exposure was not related to circulating markers of inflammation. These results suggest that chronic exposure to some pollutants may prime immune cells to mount larger inflammatory responses, possibly contributing to increased risk for inflammatory disease. https://doi.org/10.1289/EHP7089.

Geocoding Error, Spatial Uncertainty, and Implications for Exposure Assessment and Environmental Epidemiology.

Although environmental epidemiology studies often rely on geocoding procedures in the process of assigning spatial exposure estimates, geocoding methods are not commonly reported, nor are consequent errors in exposure assignment explored. Geocoding methods differ in accuracy, however, and, given the increasing refinement of available exposure models for air pollution and other exposures, geocoding error may account for an increasingly larger proportion of exposure misclassification. We used residential addresses from a reasonably large, dense dataset of asthma emergency department visits from all New York City hospitals (n = 21,183; 26.9 addresses/km2), and geocoded each using three methods (Address Point, Street Segment, Parcel Centroid). We compared missingness and spatial patterning therein, quantified distance and directional errors, and quantified impacts on pollution exposure estimates and assignment to Census areas for sociodemographic characterization. Parcel Centroids had the highest overall missingness rate (38.1%, Address Point = 9.6%, Street Segment = 6.1%), and spatial clustering in missingness was significant for all methods, though its spatial patterns differed. Street Segment geocodes had the largest mean distance error (µ = 29.2 (SD = 26.2) m; vs. µ = 15.9 (SD = 17.7) m for Parcel Centroids), and the strongest spatial patterns therein. We found substantial over- and under-estimation of pollution exposures, with greater error for higher pollutant concentrations, but minimal impact on Census area assignment. Finally, we developed surfaces of spatial patterns in errors in order to identify locations in the study area where exposures may be over-/under-estimated. Our observations provide insights towards refining geocoding methods for epidemiology, and suggest methods for quantifying and interpreting geocoding error with respect to exposure misclassification, towards understanding potential impacts on health effect estimates.

Evaluating deciduous tree leaves as biomonitors for ambient particulate matter pollution in Pittsburgh, PA, USA.

Fine particulate matter (PM2.5) air pollution varies spatially and temporally in concentration and composition and has been shown to cause or exacerbate adverse effects on human and ecological health. Biomonitoring using airborne tree leaf deposition as a proxy for particulate matter (PM) pollution has been explored using a variety of study designs, tree species, sampling strategies, and analytical methods. In the USA, relatively few have applied these methods using co-located fine particulate measurements for comparison and relying on one tree species with extensive spatial coverage, to capture spatial variation in ambient air pollution across an urban area. Here, we evaluate the utility of this approach, using a spatial saturation design and pairing tree leaf samples with filter-based PM2.5 across Pittsburgh, Pennsylvania, with the goal of distinguishing mobile and stationary sources using PM2.5 composition. Co-located filter and leaf-based measurements revealed some significant associations with traffic and roadway proximity indicators. We compared filter and leaf samples with differing protection from the elements (e.g., meteorology) and PM collection time, which may account for some variance in PM source and/or particle size capture between samples. To our knowledge, this study is among the first to use deciduous tree leaves from a single tree species as biomonitors for urban PM2.5 pollution in the northeastern USA.

Hybrid land use regression modeling for estimating spatio-temporal exposures to PM2.5, BC, and metal components across a metropolitan area of complex terrain and industrial sources.

Land use regression (LUR) modeling has become a common method for predicting pollutant concentrations and assigning exposure estimates in epidemiological studies. However, few LUR models have been developed for metal constituents of fine particulate matter (PM2.5) or have incorporated source-specific dispersion covariates in locations with major point sources. We developed hybrid AERMOD LUR models for PM2.5, black carbon (BC), and steel-related PM2.5 constituents lead, manganese, iron, and zinc, using fine-scale air pollution data from 37 sites across the Pittsburgh area. These models were designed with the aim of developing exposure estimates for time periods of interest in epidemiology studies. We found that the hybrid LUR models explained greater variability in PM2.5 (R2 = 0.79) compared to BC (R2 = 0.59) and metal constituents (R2 = 0.34-0.55). Approximately 70% of variation in PM2.5 was attributable to temporal variance, compared to 36% for BC, and 17-26% for metals. An AERMOD dispersion covariate developed using PM2.5 industrial emissions data for 207 sources was significant in PM2.5 and BC models; all metals models contained a steel mill-specific PM2.5 emissions AERMOD term. Other significant covariates included industrial land use, commercial and industrial land use, percent impervious surface, and summed railroad length.

Fine-Scale Source Apportionment Including Diesel-Related Elemental and Organic Constituents of PM2.5 across Downtown Pittsburgh.

Health effects of fine particulate matter (PM2.5) may vary by composition, and the characterization of constituents may help to identify key PM2.5 sources, such as diesel, distributed across an urban area. The composition of diesel particulate matter (DPM) is complicated, and elemental and organic carbon are often used as surrogates. Examining multiple elemental and organic constituents across urban sites, however, may better capture variation in diesel-related impacts, and help to more clearly separate diesel from other sources. We designed a "super-saturation" monitoring campaign of 36 sites to capture spatial variance in PM2.5 and elemental and organic constituents across the downtown Pittsburgh core (~2.8 km²). Elemental composition was assessed via inductively-coupled plasma mass spectrometry (ICP-MS), organic and elemental carbon via thermal-optical reflectance, and organic compounds via thermal desorption gas-chromatography mass-spectrometry (TD-GCMS). Factor analysis was performed including all constituents-both stratified by, and merged across, seasons. Spatial patterning in the resultant factors was examined using land use regression (LUR) modelling to corroborate factor interpretations. We identified diesel-related factors in both seasons; for winter, we identified a five-factor solution, describing a bus and truck-related factor [black carbon (BC), fluoranthene, nitrogen dioxide (NO2), pyrene, total carbon] and a fuel oil combustion factor (nickel, vanadium). For summer, we identified a nine-factor solution, which included a bus-related factor (benzo[ghi]fluoranthene, chromium, chrysene, fluoranthene, manganese, pyrene, total carbon, total elemental carbon, zinc) and a truck-related factor (benz[a]anthracene, BC, hopanes, NO2, total PAHs, total steranes). Geographic information system (GIS)-based emissions source covariates identified via LUR modelling roughly corroborated factor interpretations.

Spatial Patterns in Rush-Hour vs. Work-Week Diesel-Related Pollution across a Downtown Core.

Despite advances in monitoring and modelling of intra-urban variation in multiple pollutants, few studies have attempted to separate spatial patterns by time of day, or incorporated organic tracers into spatial monitoring studies. Due to varying emissions sources from diesel and gasoline vehicular traffic, as well as within-day temporal variation in source mix and intensity (e.g., rush-hours vs. full-day measures), accurately assessing diesel-related air pollution within an urban core can be challenging. We allocated 24 sampling sites across downtown Pittsburgh, Pennsylvania (2.8 km²) to capture fine-scale variation in diesel-related pollutants, and to compare these patterns by sampling interval (i.e., "rush-hours" vs. "work-week" concentrations), and by season. Using geographic information system (GIS)-based methods, we allocated sampling sites to capture spatial variation in key traffic-related pollution sources (i.e., truck, bus, overall traffic densities). Programmable monitors were used to collect integrated work-week and rush-hour samples of fine particulate matter (PM2.5), black carbon (BC), trace elements, and diesel-related organics (polycyclic aromatic hydrocarbons (PAHs), hopanes, steranes), in summer and winter 2014. Land use regression (LUR) models were created for PM2.5, BC, total elemental carbon (EC), total organic carbon (OC), elemental (Al, Ca, Fe), and organic constituents (total PAHs, total hopanes), and compared by sampling interval and season. We hypothesized higher pollution concentrations and greater spatial contrast in rush-hour, compared to full work-week samples, with variation by season and pollutant. Rush-hour sampling produced slightly higher total PM2.5 and BC concentrations in both seasons, compared to work-week sampling, but no evident difference in spatial patterns. We also found substantial spatial variability in most trace elements and organic compounds, with comparable spatial patterns using both sampling paradigms. Overall, we found higher concentrations of traffic-related trace elements and organic compounds in rush-hour samples, and higher concentrations of coal-related elements (e.g., As, Se) in work-week samples. Mean bus density was the strongest LUR predictor in most models, in both seasons, under each sampling paradigm. Within each season and constituent, the bus-related terms explained similar proportions of variance in the rush-hour and work-week samples. Rush-hour and work-week LUR models explained similar proportions of spatial variation in pollutants, suggesting that the majority of emissions may be produced during rush-hour traffic across downtown. Results suggest that rush-hour emissions may predominantly shape overall spatial variance in diesel-related pollutants.

Particulate Matter Air Pollution and Racial Differences in Cardiovascular Disease Risk.

OBJECTIVE: We aimed to assess racial differences in air pollution exposures to ambient fine particulate matter (particles with median aerodynamic diameter <2.5 µm [PM2.5]) and black carbon (BC) and their association with cardiovascular disease (CVD) risk factors, arterial endothelial function, incident CVD events, and all-cause mortality. APPROACH AND RESULTS: Data from the HeartSCORE study (Heart Strategies Concentrating on Risk Evaluation) were used to estimate 1-year average air pollution exposure to PM2.5 and BC using land use regression models. Correlates of PM2.5 and BC were assessed using linear regression models. Associations with clinical outcomes were determined using Cox proportional hazards models, adjusting for traditional CVD risk factors. Data were available on 1717 participants (66% women; 45% blacks; 59±8 years). Blacks had significantly higher exposure to PM2.5 (mean 16.1±0.75 versus 15.7±0.73µg/m3; P=0.001) and BC (1.19±0.11 versus 1.16±0.13abs; P=0.001) compared with whites. Exposure to PM2.5, but not BC, was independently associated with higher blood glucose and worse arterial endothelial function. PM2.5 was associated with a higher risk of incident CVD events and all-cause mortality combined for median follow-up of 8.3 years. Blacks had 1.45 (95% CI, 1.00-2.09) higher risk of combined CVD events and all-cause mortality than whites in models adjusted for relevant covariates. This association was modestly attenuated with adjustment for PM2.5. CONCLUSIONS: PM2.5 exposure was associated with elevated blood glucose, worse endothelial function, and incident CVD events and all-cause mortality. Blacks had a higher rate of incident CVD events and all-cause mortality than whites that was only partly explained by higher exposure to PM2.5.

Air pollutants may be environmental risk factors in chronic rhinosinusitis disease progression.

BACKGROUND: Little is known about the role of environmental exposures in the pathophysiology of chronic rhinosinusitis (CRS). In this study, we measured the impact of air pollutants (particulate matter 2.5 [PM2.5 ] and black carbon [BC]) on CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP). METHODS: Spatial modeling from pollutant monitoring sites was used to estimate exposures surrounding residences for patients meeting inclusion criteria (total patients, n = 234; CRSsNP, n = 96; CRSwNP, n = 138). Disease severity outcome measures included modified Lund-Mackay score (LMS), systemic steroids, number of functional endoscopic sinus surgeries (FESS), and 22-item Sino-Nasal Outcome Test (SNOT-22) score. PM2.5 and BC exposures were correlated with outcome measures. RESULTS: Mean PM2.5 and BC findings were not significantly different between CRSwNP and CRSsNP patients or patients with and without asthma. Among those with CRSsNP, PM2.5 was significantly associated with undergoing FESS. For each unit increase in PM2.5 , there was a 1.89-fold increased risk in the proportion of CRSsNP patients who required further surgery (p = 0.015). This association was not identified in CRSwNP patients (p = 0.445). BC was also significantly associated with SNOT-22 score in the CRSsNP group. For each 0.1-unit increase in BC, there was a 7.97-unit increase in SNOT-22 (p = 0.008). A similar, although not significant, increase in SNOT-22 was found with increasing BC in the CRSwNP group (p = 0.728). CONCLUSION: Air pollutants correlate with CRS symptom severity that may be influenced by exposure levels, with a more pronounced impact on CRSsNP patients. This study is the first to demonstrate the possible role of inhalant pollutants in CRS phenotypes, addressing a critical knowledge gap in environmental risk factors for disease progression.

Spatial variation in diesel-related elemental and organic PM2.5 components during workweek hours across a downtown core.

Capturing intra-urban variation in diesel-related pollution exposures remains a challenge, given its complex chemical mix, and relatively few well-characterized ambient-air tracers for the multiple diesel sources in densely-populated urban areas. To capture fine-scale spatial resolution (50×50m grid cells) in diesel-related pollution, we used geographic information systems (GIS) to systematically allocate 36 sampling sites across downtown Pittsburgh, PA, USA (2.8km2), cross-stratifying to disentangle source impacts (i.e., truck density, bus route frequency, total traffic density). For buses, outbound and inbound trips per week were summed by route and a kernel density was calculated across sites. Programmable monitors collected fine particulate matter (PM2.5) samples specific to workweek hours (Monday-Friday, 7 am-7 pm), summer and winter 2013. Integrated filters were analyzed for black carbon (BC), elemental carbon (EC), organic carbon (OC), elemental constituents, and diesel-related organic compounds [i.e., polycyclic aromatic hydrocarbons (PAHs), hopanes, steranes]. To our knowledge, no studies have collected this suite of pollutants with such high sampling density, with the ability to capture spatial patterns during specific hours of interest. We hypothesized that we would find substantial spatial variation for each pollutant and significant associations with key sources (e.g. diesel and gasoline vehicles), with higher concentrations near the center of this small downtown core. Using a forward stepwise approach, we developed seasonal land use regression (LUR) models for PM2.5, BC, total EC, OC, PAHs, hopanes, steranes, aluminum (Al), calcium (Ca), and iron (Fe). Within this small domain, greater concentration differences were observed in most pollutants across sites, on average, than between seasons. Higher PM2.5 and BC concentrations were found in the downtown core compared to the boundaries. PAHs, hopanes, and steranes displayed different spatial patterning across the study area by constituent. Most LUR models suggested a strong influence of bus-related emissions on pollution gradients. Buses were more dominant predictors compared to truck and vehicular traffic for several pollutants. Overall, we found substantial variation in diesel-related concentrations in a very small downtown area, which varied across elemental and organic components.

Spatial patterning in PM2.5 constituents under an inversion-focused sampling design across an urban area of complex terrain.

Health effects of fine particulate matter (PM2.5) vary by chemical composition, and composition can help to identify key PM2.5 sources across urban areas. Further, this intra-urban spatial variation in concentrations and composition may vary with meteorological conditions (e.g., mixing height). Accordingly, we hypothesized that spatial sampling during atmospheric inversions would help to better identify localized source effects, and reveal more distinct spatial patterns in key constituents. We designed a 2-year monitoring campaign to capture fine-scale intra-urban variability in PM2.5 composition across Pittsburgh, PA, and compared both spatial patterns and source effects during "frequent inversion" hours vs 24-h weeklong averages. Using spatially distributed programmable monitors, and a geographic information systems (GIS)-based design, we collected PM2.5 samples across 37 sampling locations per year to capture variation in local pollution sources (e.g., proximity to industry, traffic density) and terrain (e.g., elevation). We used inductively coupled plasma mass spectrometry (ICP-MS) to determine elemental composition, and unconstrained factor analysis to identify source suites by sampling scheme and season. We examined spatial patterning in source factors using land use regression (LUR), wherein GIS-based source indicators served to corroborate factor interpretations. Under both summer sampling regimes, and for winter inversion-focused sampling, we identified six source factors, characterized by tracers associated with brake and tire wear, steel-making, soil and road dust, coal, diesel exhaust, and vehicular emissions. For winter 24-h samples, four factors suggested traffic/fuel oil, traffic emissions, coal/industry, and steel-making sources. In LURs, as hypothesized, GIS-based source terms better explained spatial variability in inversion-focused samples, including a greater contribution from roadway, steel, and coal-related sources. Factor analysis produced source-related constituent suites under both sampling designs, though factors were more distinct under inversion-focused sampling.

Spatial variation in inversion-focused vs 24-h integrated samples of PM2.5 and black carbon across Pittsburgh, PA.

A growing literature explores intra-urban variation in pollution concentrations. Few studies, however, have examined spatial variation during "peak" hours of the day (e.g., rush hours, inversion conditions), which may have strong bearing for source identification and epidemiological analyses. We aimed to capture "peak" spatial variation across a region of complex terrain, legacy industry, and frequent atmospheric inversions. We hypothesized stronger spatial contrast in concentrations during hours prone to atmospheric inversions and heavy traffic, and designed a 2-year monitoring campaign to capture spatial variation in fine particles (PM2.5) and black carbon (BC). Inversion-focused integrated monitoring (0600-1100 hours) was performed during year 1 (2011-2012) and compared with 1-week 24-h integrated results from year 2 (2012-2013). To allocate sampling sites, we explored spatial distributions in key sources (i.e., traffic, industry) and potential modifiers (i.e., elevation) in geographic information systems (GIS), and allocated 37 sites for spatial and source variability across the metropolitan domain (~388 km(2)). Land use regression (LUR) models were developed and compared by pollutant, season, and sampling method. As expected, we found stronger spatial contrasts in PM2.5 and BC using inversion-focused sampling, suggesting greater differences in peak exposures across urban areas than is captured by most integrated saturation campaigns. Temporal variability, commercial and industrial land use, PM2.5 emissions, and elevation were significant predictors, but did not more strongly predict concentrations during peak hours.

Indoor air sampling for fine particulate matter and black carbon in industrial communities in Pittsburgh.

Impacts of industrial emissions on outdoor air pollution in nearby communities are well-documented. Fewer studies, however, have explored impacts on indoor air quality in these communities. Because persons in northern climates spend a majority of their time indoors, understanding indoor exposures, and the role of outdoor air pollution in shaping such exposures, is a priority issue. Braddock and Clairton, Pennsylvania, industrial communities near Pittsburgh, are home to an active steel mill and coke works, respectively, and the population experiences elevated rates of childhood asthma. Twenty-one homes were selected for 1-week indoor sampling for fine particulate matter (PM2.5) and black carbon (BC) during summer 2011 and winter 2012. Multivariate linear regression models were used to examine contributions from both outdoor concentrations and indoor sources. In the models, an outdoor infiltration component explained 10 to 39% of variability in indoor air pollution for PM2.5, and 33 to 42% for BC. For both PM2.5 models and the summer BC model, smoking was a stronger predictor than outdoor pollution, as greater pollutant concentration increases were identified. For winter BC, the model was explained by outdoor pollution and an open windows modifier. In both seasons, indoor concentrations for both PM2.5 and BC were consistently higher than residence-specific outdoor concentration estimates. Mean indoor PM2.5 was higher, on average, during summer (25.8±22.7 µg/m3) than winter (18.9±13.2 µg/m3). Contrary to the study's hypothesis, outdoor concentrations accounted for only little to moderate variability (10 to 42%) in indoor concentrations; a much greater proportion of PM2.5 was explained by cigarette smoking. Outdoor infiltration was a stronger predictor for BC compared to PM2.5, especially in winter. Our results suggest that, even in industrial communities of high outdoor pollution concentrations, indoor activities--particularly cigarette smoking--may play a larger role in shaping indoor exposures.

Saturation sampling for spatial variation in multiple air pollutants across an inversion-prone metropolitan area of complex terrain.

BACKGROUND: Characterizing intra-urban variation in air quality is important for epidemiological investigation of health outcomes and disparities. To date, however, few studies have been designed to capture spatial variation during select hours of the day, or to examine the roles of meteorology and complex terrain in shaping intra-urban exposure gradients. METHODS: We designed a spatial saturation monitoring study to target local air pollution sources, and to understand the role of topography and temperature inversions on fine-scale pollution variation by systematically allocating sampling locations across gradients in key local emissions sources (vehicle traffic, industrial facilities) and topography (elevation) in the Pittsburgh area. Street-level integrated samples of fine particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were collected during morning rush and probable inversion hours (6-11 AM), during summer and winter. We hypothesized that pollution concentrations would be: 1) higher under inversion conditions, 2) exacerbated in lower-elevation areas, and 3) vary by season. RESULTS: During July - August 2011 and January - March 2012, we observed wide spatial and seasonal variability in pollution concentrations, exceeding the range measured at regulatory monitors. We identified elevated concentrations of multiple pollutants at lower-elevation sites, and a positive association between inversion frequency and NO2 concentration. We examined temporal adjustment methods for deriving seasonal concentration estimates, and found that the appropriate reference temporal trend differs between pollutants. CONCLUSIONS: Our time-stratified spatial saturation approach found some evidence for modification of inversion-concentration relationships by topography, and provided useful insights for refining and interpreting GIS-based pollution source indicators for Land Use Regression modeling.