1
|
Di Loro PA, Mingione M, Lipsitt J, Batteate CM, Jerrett M, Banerjee S. BAYESIAN HIERARCHICAL MODELING AND ANALYSIS FOR ACTIGRAPH DATA FROM WEARABLE DEVICES. Ann Appl Stat 2023; 17:2865-2886. [PMID: 38283128 PMCID: PMC10815935 DOI: 10.1214/23-aoas1742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
The majority of Americans fail to achieve recommended levels of physical activity, which leads to numerous preventable health problems such as diabetes, hypertension, and heart diseases. This has generated substantial interest in monitoring human activity to gear interventions toward environmental features that may relate to higher physical activity. Wearable devices, such as wrist-worn sensors that monitor gross motor activity (actigraph units) continuously record the activity levels of a subject, producing massive amounts of high-resolution measurements. Analyzing actigraph data needs to account for spatial and temporal information on trajectories or paths traversed by subjects wearing such devices. Inferential objectives include estimating a subject's physical activity levels along a given trajectory; identifying trajectories that are more likely to produce higher levels of physical activity for a given subject; and predicting expected levels of physical activity in any proposed new trajectory for a given set of health attributes. Here, we devise a Bayesian hierarchical modeling framework for spatial-temporal actigraphy data to deliver fully model-based inference on trajectories while accounting for subject-level health attributes and spatial-temporal dependencies. We undertake a comprehensive analysis of an original dataset from the Physical Activity through Sustainable Transport Approaches in Los Angeles (PASTA-LA) study to ascertain spatial zones and trajectories exhibiting significantly higher levels of physical activity while accounting for various sources of heterogeneity.
Collapse
Affiliation(s)
| | | | - Jonah Lipsitt
- Department of Environmental Health Sciences, University of California, Los Angeles
| | - Christina M. Batteate
- Center of Occupational and Environmental Health, University of California, Los Angeles
| | - Michael Jerrett
- Department of Environmental Health Sciences, University of California, Los Angeles
| | - Sudipto Banerjee
- Department of Biostatistics, University of California, Los Angeles
| |
Collapse
|
2
|
Jerrett M, Nau CL, Young DR, Butler RK, Batteate CM, Padilla A, Tartof SY, Su J, Burnett RT, Kleeman MJ. Air pollution and the sequelae of COVID-19 patients: A multistate analysis. Environ Res 2023; 236:116814. [PMID: 37558120 DOI: 10.1016/j.envres.2023.116814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
IMPORTANCE Recent evidence links air pollution to the severity COVID-19 symptoms and to death from the disease. To date, however, few studies have assessed whether air pollution affects the sequelae to more severe states or recovery from COVID-19 in a cohort with individual data. OBJECTIVE To assess how air pollution affects the transition to more severe COVID-19 states or to recovery from COVID-19 infection in a cohort with detailed patient information. DESIGN AND OUTCOMES We used a cohort design that followed patients admitted to hospital in the Kaiser Permanente Southern California (KPSC) Health System, which has 4.7 million members with characteristics similar to the general population. Enrollment began on 06/01/2020 and ran until 01/30/2021 for all patients admitted to hospital while ill with COVID-19. All possible states of sequelae were considered, including deterioration to intensive care, to death, discharge to recovery, or discharge to death. Transition risks were estimated with a multistate model. We assessed exposure using chemical transport model that predicted ambient concentrations of nitrogen dioxide, ozone, and fine particulate matter (PM2.5) at a 1 km scale. RESULTS Each increase in PM2.5 concentration equivalent to the interquartile range was associated with increased risk of deterioration to intensive care (HR of 1.16; 95% CI: 1.12-1.20) and deterioration to death (HR of 1.11; 95% CI: 1.04-1.17). Results for ozone were consistent with PM2.5 effects, but ozone also affected the transition from recovery to death: HR of 1.24 (95% CI: 1.01-1.51). NO2 had weaker effects but displayed some elevated risks. CONCLUSIONS PM2.5 and ozone were significantly associated with transitions to more severe states while in hospital and to death after discharge from hospital. Reducing air pollution could therefore lead to improved prognosis for COVID-19 patients and a sustainable means of reducing the health impacts of coronaviruses now and in the future.
Collapse
Affiliation(s)
- Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles 650 Charles Young Dr. S, 56-070 CHS Box 951772, Los Angeles, CA, 90095, USA.
| | - Claudia L Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Rebecca K Butler
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Christina M Batteate
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles 650 Charles Young Dr. S, 56-070 CHS Box 951772, Los Angeles, CA, 90095, USA
| | - Ariadna Padilla
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Sara Y Tartof
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave., 5th Floor, Pasadena, CA, 91101, USA
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720, USA
| | - Richard T Burnett
- Population Studies Division, Environmental Health Directorate, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California, Davis, 1 Sheilds Avenue, Davis, CA, 95616, USA
| |
Collapse
|
3
|
Jerrett M, Nau CL, Young DR, Butler RK, Batteate CM, Su J, Burnett RT, Kleeman MJ. Air pollution and meteorology as risk factors for COVID-19 death in a cohort from Southern California. Environ Int 2023; 171:107675. [PMID: 36565571 PMCID: PMC9715495 DOI: 10.1016/j.envint.2022.107675] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Recent evidence links ambient air pollution to COVID-19 incidence, severity, and death, but few studies have analyzed individual-level mortality data with high quality exposure models. METHODS We sought to assess whether higher air pollution exposures led to greater risk of death during or after hospitalization in confirmed COVID-19 cases among patients who were members of the Kaiser Permanente Southern California (KPSC) healthcare system (N=21,415 between 06-01-2020 and 01-31-2022 of whom 99.85 % were unvaccinated during the study period). We used 1 km resolution chemical transport models to estimate ambient concentrations of several common air pollutants, including ozone, nitrogen dioxide, and fine particle matter (PM2.5). We also derived estimates of pollutant exposures from ultra-fine particulate matter (PM0.1), PM chemical species, and PM sources. We employed Cox proportional hazards models to assess associations between air pollution exposures and death from COVID-19 among hospitalized patients. FINDINGS We found significant associations between COVID-19 death and several air pollution exposures, including: PM2.5 mass, PM0.1 mass, PM2.5 nitrates, PM2.5 elemental carbon, PM2.5 on-road diesel, and PM2.5 on-road gasoline. Based on the interquartile (IQR) exposure increment, effect sizes ranged from hazard ratios (HR) = 1.12 for PM2.5 mass and PM2.5 nitrate to HR ∼ 1.06-1.07 for other species or source markers. Humidity and temperature in the month of diagnosis were also significant negative predictors of COVID-19 death and negative modifiers of the air pollution effects. INTERPRETATION Air pollution exposures and meteorology were associated the risk of COVID-19 death in a cohort of patients from Southern California. These findings have implications for prevention of death from COVID-19 and for future pandemics.
Collapse
Affiliation(s)
- Michael Jerrett
- Department of Environmental Health Sciences, University of California, Los Angeles 650 Charles Young Dr. S., 56-070 CHS Box 951772, Los Angeles, CA, 90095, United States.
| | - Claudia L Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Rebecca K Butler
- Department of Research & Evaluation, Kaiser Permanente Southern California 100 S. Los Robles Ave., 5th Floor, Pasadena, CA 91101, United States
| | - Christina M Batteate
- Department of Environmental Health Sciences, University of California, Los Angeles 650 Charles Young Dr. S., 56-070 CHS Box 951772, Los Angeles, CA, 90095, United States
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 2121 Berkeley Way, Room 5302, Berkeley, CA 94720, United States
| | - Richard T Burnett
- Population Studies Division, Environmental Health Directorate, Health Canada 251 Sir Frederick Banting Driveway, Ottawa, Ontario K1A 0K9, Canada
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California, Davis 1 Sheilds Avenue, Davis, CA 95616, United States
| |
Collapse
|
4
|
Malloy TF, Zaunbrecher VM, Batteate CM, Blake A, Carroll WF, Corbett CJ, Hansen SF, Lempert RJ, Linkov I, McFadden R, Moran KD, Olivetti E, Ostrom NK, Romero M, Schoenung JM, Seager TP, Sinsheimer P, Thayer KA. Advancing Alternative Analysis: Integration of Decision Science. Environ Health Perspect 2017; 125:066001. [PMID: 28669940 PMCID: PMC5743447 DOI: 10.1289/ehp483] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 05/09/2016] [Accepted: 09/19/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. OBJECTIVES We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. METHODS A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. RESULTS We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. CONCLUSIONS We advance four recommendations: a) engaging the systematic development and evaluation of decision approaches and tools; b) using case studies to advance the integration of decision analysis into alternatives analysis; c) supporting transdisciplinary research; and d) supporting education and outreach efforts. https://doi.org/10.1289/EHP483.
Collapse
Affiliation(s)
- Timothy F Malloy
- UCLA School of Law, University of California, Los Angeles (UCLA), Los Angeles, California, USA
- UCLA Fielding School of Public Health, UCLA, Los Angeles, California, USA
- University of California Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | - Virginia M Zaunbrecher
- UCLA School of Law, University of California, Los Angeles (UCLA), Los Angeles, California, USA
- UCLA Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | | | - Ann Blake
- Environmental and Public Health Consulting, Alameda, California, USA
| | - William F Carroll
- Department of Chemistry, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Charles J Corbett
- UCLA Anderson School of Management, UCLA, Los Angeles, California, USA
- UCLA Institute of the Environment and Sustainability, UCLA, Los Angeles, California, USA
| | - Steffen Foss Hansen
- Department of Environmental Engineering, Technical University of Denmark, Copenhagen, Denmark
| | | | - Igor Linkov
- U.S. Army Engineer Research and Development Center, Concord, Massachusetts, USA
| | | | | | - Elsa Olivetti
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Nancy K Ostrom
- Safer Products and Workplaces Program, Department of Toxic Substances Control, Sacramento, California, USA
| | - Michelle Romero
- UCLA Fielding School of Public Health, UCLA, Los Angeles, California, USA
- University of California Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | - Julie M Schoenung
- Henry Samueli School of Engineering, University of California, Irvine, Irvine, California, USA
| | - Thomas P Seager
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
| | - Peter Sinsheimer
- UCLA Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Kristina A Thayer
- Office of Health Assessment and Translation, National Toxicology Program, National Institute of Environmental Health Sciences, Morrisville, North Carolina, USA
| |
Collapse
|