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Dissertation/Thesis Abstract

Exposure to ambient fine particulate matter and health effects in the Medicare population
by Eftim, Sorina E., Ph.D., The Johns Hopkins University, 2007, 167; 3262360
Abstract (Summary)

Time-series and cohort studies of the effect of exposure to ambient air pollution on human health have been powerful tools in advancing our understanding in this area. The work presented in this thesis takes advantage of both time-series and cohort-study designs to estimate short-term and chronic health effects of exposure to PM2.5 in a susceptible population across the United States. Chapter 2 presents an overview of the time-series and cohort studies approaches for estimating the relative risk of mortality from particulate air pollution and discusses the statistical issues and challenges inherent in these studies. The American Cancer Society study (ACS) (Pope et al., 1995) and the Harvard Six Cities study (SCS) (Dockery et al., 1993a) are landmark cohort studies for estimating the chronic effects of fine particulate matter (PM2.5) on mortality. In Chapter 3, we estimate the chronic effects of PM2.5 on mortality for the period 2000-2002 using mortality data cohorts of Medicare participants and PM2.5 levels from monitors in the same counties included in the SCS and the ACS. We estimate the mortality risk associated with air pollution adjusting for individual-level factors and area-level covariates. We propose that the Medicare files can be used to construct cohorts for tracking the risk of air pollution over time.

In Chapter 4 we evaluate the transboundary health impact of a wildfire episode on a susceptible population of interest. The smoke plume generated from the forest fires in Quebec, Canada in July 2002 had major impacts on air quality across the east coast of the US. To evaluate the public health impact of smoke exposure on the elderly population in the US, hospital admission rates for cardiopulmonary causes were estimated in counties located in 11 states in the northeastern and mid-Atlantic region of the US, before and during the period of plume presence. We estimated significant associations between short-term increases in ambient PM2.5 concentrations and hospitalizations for cardiorespiratory diseases within 11 of the affected states. This research adds to the growing body of literature demonstrating the significant impact of transboundary air pollution on the health of the elderly.

Indexing (document details)
Advisor: Diette, Gregory B.
School: The Johns Hopkins University
School Location: United States -- Maryland
Source: DAI-B 68/04, Dissertation Abstracts International
Subjects: Public health, Environmental science
Keywords: Fine particulates, Medicare, Particulate matter
Publication Number: 3262360
ISBN: 978-1-109-99566-4
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