Regional (PA, WV, OH) Study of Air Pollution and Health Effects

1
Regional (PA, WV, OH) Study of Air Pollution and
Health Effects Judith Rager, MPH University of
Pittsburgh Academic Center for Excellence in
Environmental Public Health Tracking (UPACE-EPHT)
Background
Results
Current Analyses Assessing the
comparability of data

• Process of Obtaining Data and Comparability of
  Data Elements
• Hospitalization data was obtained from data
  stewards in PA and WV. To date, we have been
  unable to obtain data from Ohio.
• We have identified a number of issues related to
  obtaining and using hospitalization data from
  data stewards.

• Regional air pollutants from steel, coking, and
  other industries in southwestern Pennsylvania,
  eastern Ohio, and the West Virginia panhandle
  heavily influence atmospheric conditions in this
  tri-state area. Therefore, it is of interest to
  study the acute health effects of these
  pollutants regionally.

We are currently examining rates, patterns, and
characteristics of hospital transfers by county
in SW PA among patients hospitalized with Acute
Myocardial Infarction (primary discharge
diagnosis of ICD-9 code 410). Transfer status
is being assessed using two approaches with
criteria based on 1) dates of discharge and
admission and 2) discharge status.

• bureaucratic issues
• interpretation of HIPAA regulations
• differences in the types of variables collected
  by agency and/or available to researcher

• Health effects data, such as hospitalization
  data, is not readily available from national data
  sources. The type of agency responsible for
  hospital discharge data, and the method of
  collection, composition, and quality of
  hospitalization data vary from state to state.

Future Research for Project

• Evaluate and develop techniques for using
  regional data for health effects studies of air
  pollution.
• Conduct a case-crossover study of the
  association of specific air pollutants and health
  effects (including asthma and acute myocardial
  infarction).

Methodology

• Request hospitalization data on cardiovascular
  and respiratory diseases (ICD-9 codes 390-519)
  from data stewards in Pennsylvania (Pennsylvania
  Health Care Cost Containment Council), West
  Virginia, (West Virginia Health Care Authority),
  and Ohio (Ohio Hospital Association).
• Assess the process of obtaining such data.
• Assess the comparability and quality of the
  data.

Significance

• Environmental exposures, whether in air, soil,
  or water do not follow administrative boundaries.
  
• The ability to link health data from tracking
  and non-tracking states is critical to the
  overall goal of the national environmental public
  health tracking initiative.

This work was supported by CDC ( 5 U19
EH000103-04).