# Air Pollution and Mortality Risk in Veterans with Chronic Respiratory Disease: Assessing the Role of Individual and Place-Based Risk Factors

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2024 · $343,146

## Abstract

PROJECT SUMMARY/ABSTRACT
Chronic respiratory diseases (CRD), such as asthma and chronic obstructive pulmonary disease, impact over
554 million people worldwide and are major contributors to the non-communicable disease burden in the
United States. Individuals with CRD show pronounced disparities in disease risk by factors such as age, sex,
community type, and environment. Air pollution is one environmental risk factor of concern with nearly 135
million people in the U.S. residing in counties experiencing poor air quality. Evidence suggests that air pollution
regulatory standards, despite their design to protect public health, may be inadequate for CRD populations
who exhibit elevated sensitivity to even low levels of air pollution exposure. It is critical to estimate air pollution
health effects, specifically for vulnerable populations, and identify the underlying and unexplored factors that
elevate risk, including the intersection between personal and community-level disadvantage. Minimizing
vulnerabilities across groups and by environment is a core principle of environmental justice. Our central
hypothesis is that individuals with diagnosed CRD represent a high vulnerability population who display
increased mortality risk from acute exposure to fine particulate matter (PM2.5) and ozone air pollution. An
additional emphasis is to identify which individual and neighborhood characteristics increase air pollution
inequities among CRD patients and unpack their joint contribution to poor health outcomes. To test our
hypothesis, we will utilize 20 years of records from the Veterans Health Administration (VHA) and
spatiotemporally align individual patient data with state-of-the-art high-resolution air pollution models,
environmental metrics, and community sociodemographic and social vulnerability characteristics. Detailed VHA
records provides data innovations absent from many large cohorts, including diagnosis of comorbidities,
geocoded home addresses to reduce exposure misclassification, and individual characteristics and behavior,
such as smoking status and body mass index. In Aim 1, we will estimate the mortality risk in CRD populations
attributed to daily PM2.5 and ozone exposure and identify individual characteristics that exacerbate
susceptibility. In Aim 2, we will evaluate the intersection between individual vulnerabilities and neighborhood
inequities for air pollution associated mortality risk in CRD populations and estimate the differential risk of
these contributing causes. In Aim 3, we will estimate the association between air pollution exposure and
underlying mortality cause, and quantify non-linear exposure-response relationships, including low-dose
exposures. Our research will have a meaningful public health impact by informing air quality regulations as
they pertain to individuals with CRD and provide evidence for behavioral interventions and treatment of CRD
populations to reduce mortality risk. As a modifiable risk factor, reductions ...

## Key facts

- **NIH application ID:** 10855504
- **Project number:** 1R01ES036225-01
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Jesse David Berman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $343,146
- **Award type:** 1
- **Project period:** 2024-08-07 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10855504

## Citation

> US National Institutes of Health, RePORTER application 10855504, Air Pollution and Mortality Risk in Veterans with Chronic Respiratory Disease: Assessing the Role of Individual and Place-Based Risk Factors (1R01ES036225-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10855504. Licensed CC0.

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