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Air pollution and cardiovascular disease: from the perspectives of both short- and long-term exposure

Duan, Chunzhe (2017) Air pollution and cardiovascular disease: from the perspectives of both short- and long-term exposure. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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One of the potential risk factors for CVD is ambient air pollution. This dissertation consists of three manuscripts, in which we examined the association between both short- and long-term air pollution exposure and clinical and subclinical CVD.
The first manuscript investigated the short-term effect of multiple pollutants, PM2.5, O3, NO2 and SO2 on CVD emergency room visits in Allegheny County, PA in 1999 – 2011, using a case-crossover design. We found that per IQR increase of O3 exposure (25.52 ppb), there was 6.6% (95% CI: 0.8% - 12.7%) increase in the odds of an acute myocardial infarction (AMI) emergency room visit. Among women and Blacks, we observed the association between PM2.5 and AMI. This association persisted in analyses stratified by age, race, gender, season, as well in the later years with lower exposure levels. There was also a suggestive association between PM2.5 and NO2 and peripheral vascular disease.
The second manuscript examined the long-term exposure to PM2.5 and O3 over five years as a predictor for subclinical atherosclerosis measured approximately seven years later in a cohort among mid-life women from the multicenter multiethnicity cohort study, the Study of Women’s Health Across the Nation (SWAN). Among these 1188 women, a 1 µg/m3 higher yearly cumulative exposure to PM2.5 over 5 years was associated with an 8.0 µm (95% CI: 1.0 – 15.1) greater mean of maximum CCA IMT at later mid-life.
The third manuscript was a prospective study that examined the association between PM2.5 and O3 and progression of subclinical atherosclerosis during a 2-year follow-up at only two sites, Pittsburgh and Chicago of SWAN. In the primary analysis, a 1 μg/m3 higher yearly mean exposure to PM2.5 during the follow-up was associated with a 4.28 (95% CI: 0.02 – 8.54) μm per year increase of mean of maximum CIMT progression, after adjusting for confounders. Yearly mean exposure to PM2.5 during the follow-up contributed to plaque index progression adjusting for socioeconomic factors, but not in the fully adjusted model.
These findings provide additional evidence that both short- and long-term exposure to air pollution may have significant deleterious effects on heart health. This is of public health significance because the reduction of the ambient air pollution is at the policy level. These evidences imply further regulations needed for public health benefit.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Duan, Chunzhechd52@pitt.educhd520000-0002-5638-9997
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTalbott, Evelyneot1@pitt.edueot1
Committee MemberBarinas-Mitchell, Emmaejb4@pitt.eduejb4
Committee MemberBrooks, Mariambrooks@pitt.edumbrooks
Committee MemberBilonick, Richardrab45@pitt.edurab45
Date: 25 September 2017
Date Type: Publication
Defense Date: 22 June 2017
Approval Date: 25 September 2017
Submission Date: 20 July 2017
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 217
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Air Pollution, Cardiovascular Disease, Subclinical Atherosclerosis, short-term exposure, long-term exposure
Date Deposited: 25 Sep 2017 14:59
Last Modified: 01 Sep 2022 05:15


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