The proposed project is responsive to PA-13-302. The objective of this proposal is to extend our work on the health effects of occupational exposures to particulate matter. We will extend follow-up of incident IHD in the active cohort for 5 more years (total of 20 years) and follow subjects past termination of employment, linking the cohort to Medicare claims and cause specific mortality.
Aim 1 : Develop job-exposure matrices (JEMs) for PM and selected chemicals based on job-level exposures rather than distinct exposure groups (DEGs), adjusting for respirator use.
Aim 2 : Examine the impact of co- exposure to chemicals and physical stressors?noise and heat?as well as job stress, as independent risk factors for IHD incidence, and as potential confounders, intermediates and effect modifiers of the cardiovascular effects of PM2.5 exposure among all active workers in aluminum smelters and fabrication facilities.
Aim 3 : Explore the contribution of plant level, community and early life social and environmental characteristics to the incidence of cardiovascular disease.
Aim 4 : Estimate the associations between cumulative exposure to PM2.5 (as well as the coarse particle fraction PM2.5 - PM10) and longitudinal decline in pulmonary function.
Aim 5 : Examine the relationships between cumulative exposure to PM2.5, chemicals and COPD and CVD mortality, taking account of health status (risk score while actively employed) and new information on health status after age 65 (after leaving work) derived from linked Medicare claims files. Viewed altogether, continuation of the Alcoa study with the assembled team of investigators provides an unparalleled opportunity to address a host of critical empiric and methodologic issues previously unapproachable. In addition to understanding better what aspects of PM exposure contribute to acute and chronic risk of IHD, COPD and accelerated pulmonary function decline, we can learn how PM interacts with the most ubiquitous of workplace co-exposures as well as the contributions of personal, plant level and social determinants by applying state-of-the-art methods in measurement science and epidemiology.

Public Health Relevance

The Alcoa research infrastructure?linking quantitative exposure measures to myriad hazards of active workers whose behavior, social environment and health status from pre-employment through retirement to death are fully observed-- provides a unique opportunity to extend our work on the health effects of occupational exposures to small particles (PM2.5). We will extend follow-up of incident ischemic heart disease in the active cohort for 5 more years (total of 20 years) and follow subjects past termination of employment, linking the cohort to Medicare claims and cause specific mortality.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Research Project (R01)
Project #
5R01OH009939-07
Application #
9519581
Study Section
Safety and Occupational Health Study Section (SOH)
Project Start
2011-09-01
Project End
2020-08-31
Budget Start
2018-09-01
Budget End
2019-08-31
Support Year
7
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94304
Pensa, Mellisa A; Galusha, Deron H; Cantley, Linda F (2018) Patterns of Opioid Prescribing and Predictors of Chronic Opioid Use in an Industrial Cohort, 2003 to 2013. J Occup Environ Med 60:457-461
Liu, Sa; Noth, Elizabeth; Eisen, Ellen et al. (2018) Respirator use and its impact on particulate matter exposure in aluminum manufacturing facilities. Scand J Work Environ Health 44:547-554
Rehkopf, David H; Modrek, Sepideh; Cantley, Linda F et al. (2017) Social, Psychological, And Physical Aspects Of The Work Environment Could Contribute To Hypertension Prevalence. Health Aff (Millwood) 36:258-265
Costello, Sadie; Neophytou, Andreas M; Brown, Daniel M et al. (2016) Incident Ischemic Heart Disease After Long-Term Occupational Exposure to Fine Particulate Matter: Accounting for 2 Forms of Survivor Bias. Am J Epidemiol 183:861-8
Brown, Daniel M; Petersen, Maya; Costello, Sadie et al. (2015) Occupational Exposure to PM2.5 and Incidence of Ischemic Heart Disease: Longitudinal Targeted Minimum Loss-based Estimation. Epidemiology 26:806-14
Liu, Sa; Noth, Elizabeth M; Dixon-Ernst, Christine et al. (2014) Particle Size Distribution in Aluminum Manufacturing Facilities. Environ Pollut (Tor) 3:79-88
Neophytou, Andreas M; Costello, Sadie; Brown, Daniel M et al. (2014) Marginal structural models in occupational epidemiology: application in a study of ischemic heart disease incidence and PM2.5 in the US aluminum industry. Am J Epidemiol 180:608-15
Noth, Elizabeth M; Dixon-Ernst, Christine; Liu, Sa et al. (2014) Development of a job-exposure matrix for exposure to total and fine particulate matter in the aluminum industry. J Expo Sci Environ Epidemiol 24:89-99
Costello, Sadie; Brown, Daniel M; Noth, Elizabeth M et al. (2014) Incident ischemic heart disease and recent occupational exposure to particulate matter in an aluminum cohort. J Expo Sci Environ Epidemiol 24:82-8
Picciotto, Sally; Brown, Daniel M; Chevrier, Jonathan et al. (2013) Healthy worker survivor bias: implications of truncating follow-up at employment termination. Occup Environ Med 70:736-42