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RAND Presentation

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Amrutasri Nori-Sarma

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Transcript of RAND Presentation

“Temperature, Air Pollution, and Human Health Burden in Urban India: Fieldwork, Methods, and Preliminary Results”
PhD Student
Adviser: Prof Michelle Bell, Yale University F&ES
DC Health Research Seminar Series, RAND, 28 March 2017
Amruta Nori-Sarma
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Air Pollution, Temperature and Health in the US (760 Studies)
Environment and Health in the US
Temperature and Mortality, France 2003
INDIA
Why India?
Extreme environmental conditions

Sensitive Populations
Urban / rural
Transient

Massive population, with correspondingly large burden of disease

Therefore, new research is needed
DATA COLLECTION EFFORTS
EXPOSURE DATA
HEALTH OUTCOMES DATA
Temperature
Measurements from Indian Meteorological Department
Meteorological data from National Oceanic and Atmospheric Administration (NOAA)

Air Pollution:
Measurements from Central Pollution Control Board
Sampling Campaigns - Pilot in Dec 2015, seasonal campaigns in 2016/2017
Focus on NO2 (traffic pollution); PM2.5 and PM10
Source: Nori-Sarma A, Gurung A et al."Opportunities and Challenges in Public Health Data Collection in Southern Asia: Examples from Western India and Kathmandu Valley, Nepal." In preparation.
Mysore
Mumbai
Sampling campaign, 2015 until Present
Pilot Sampling
Ambient Pollution
NO2
Passive Sampling
Source: Azhar GS, Mavalankar D, Nori-Sarma A, Rajiva A, Dutta P, et al. (2014) Heat-Related Mortality in India: Excess All-Cause Mortality Associated with the 2010 Ahmedabad Heat Wave. PLoS ONE 9(3): e91831. doi:10.1371/journal.pone.0091831
Temperatures and daily all-cause mortality, 2010 study period vs. 2009–2011 reference period
This project was supported by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education, and by the US Environmental Protection Agency through a Science to Achieve Results (STAR) fellowship.

Acknowledgements: Yale Institute for Biospheric Studies, Enders Dissertation Research Grant, MacMillan Center, Tropical Resources Institute, IIPH-Gandhinagar, Univ of Mysore, JSS University Mysore, Bhoroka Charitable Trust NGO, Healis-Sekhsaria Institute of Public Health
Jaime Madrigano, RAND
Churu
Jaipur
Himmatnagar
Idar
14 days of NO2 sampling, 15 locations
Low, medium and high pollution
Palmes tubes and Ogawa badges
Spatial heterogeneity of air pollution levels
Seasonal Sampling
14 days of NO2 sampling, 150 locations
Palmes tubes; 15 Ogawa badges
Sites selected using combination of purposeful and random site selection

Temperature and Mortality in 11 US cities, 1973-1994
Vandentorren, S., Suzan, F., Medina, S., Pascal, M., Maulpoix, A., Cohen, J. C., & Ledrans, M. (2004). Mortality in 13 French cities during the August 2003 heat wave. American Journal of Public Health, 94(9), 1518–1520.
What's Next?
Dissertation Aim 3:
Burden of Obstructive Lung Disease (BOLD) cohort in Mysore - link air pollution exposure
Ongoing Temperature / Mortality analysis:
Impact of alternative HW definitions on Health Outcomes
Winter NO2 Concentrations in Mysore (PPB)
model R-squared = 0.402
Post-Monsoon NO2 Concentrations in Mysore (PPB)
model R-squared = 0.381
Curriero, F. C., Heiner, K. S., Samet, J. M., Zeger, S. L., Strug, L., & Patz, J. a. (2002). Temperature and mortality in 11 cities of the eastern United States. Am J Epidemiol, 155(1), 80–87.
Available online at: https://www.cdc.gov/air/pollutants.htm
ESCAPE Study
European Study of Cohorts for Air Pollution Effects
Purpose: to investigate long-term effects on human health of exposure to air pollution in Europe.
Current estimates of the European health impact of especially fine particles in the air are large.
However, available estimates are primarily based on exposure response relationships established in studies from North America.
There is an urgent need to perform studies in Europe on recent and current exposures, and to use refined exposure assessment tools.

20+ studies across Europe
Temperature Mortality Relationships, by Community
METHODS
1. Temperature / Mortality Relationship:

temperature (degrees Centigrade)
Relative Risk of Mortality
2. Effects of heat waves:
3. Association between heat wave effect estimates for mortality and heat wave characteristics:
4. Combining effect estimates for heat wave characteristics across heat waves:
Wait - what is a heat wave, exactly?
No single definition
Threshold-based
Absolute temperature, quantile of temperature, meteorological variables
IMD definition is more complicated
Depends on location, baseline temperature
Only today and tomorrow - no advance forecasting
Roads of Mysore
300m grid overlay
Pilot sampling sites
NO2 PPB - IDW
15 sites selected:
5 high pollution
5 medium
5 low
SITES FOR SAMPLING
130 Sites Selected: Systematic Random Sampling
Preference for high pollution
Preference for roads
Preference for buildings
11 Sites eliminated due to infeasibility
Remaining 16 Sites selected using Purposeful Selection to fill gaps
Univariate Kriging model:
Kriging is the Best Linear Unbiased Prediction (BLUP) of a random field; the predicted value at any unsampled location is a linear estimate of the value at sampled locations
Kriging allows us to estimate the variance surface across a spatial interpolation
Can also interpolate based on covariates
Why IDW?
Explicitly makes the assumption that things that are close to one another are more alike than those that are farther apart.
To predict a value for any unmeasured location, IDW uses the measured values surrounding the prediction location.
The measured values closest to the prediction location have more influence on the predicted value than those farther away.

More appropriate than Kriging for the pilot data, since we only have 15 sampling sites


Outline:
Background and Existing Literature

Why India?
Environmental Differences
Population Differences

Heat Wave Work

Air Pollution Work

Future Research Directions
We should develop studies in India rather than estimating burden of disease using studies in N. America, Europe
Full transcript