Spatiotemporal Analysis to Assess Linkage between Industrial Sources of Lead (Pb) Emissions and Hypertension in North Carolina
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Lead (Pb) exposures increase the risk of adverse cardiovascular outcomes, particularly among Black populations due to increased risk of exposure to Pb and coexposures with other social and environmental risk factors. Previous literature has identified several types of businesses emitting Pb, including airports, shooting ranges, mines, and racetracks. Because Pb may accumulate in soil, we use spatiotemporal analyses to identify associations between operating and closed Pb-emitting businesses and incident hypertension diagnoses for a random sample of patients within the University of North Carolina healthcare system between 2004-2018.
We previously identified relevant sources of Pb in the peer-reviewed literature and EPA systems that track Pb emissions. Airports using leaded fuel, shooting ranges, mines, and racetracks in North Carolina were geolocated using data from the Federal Aviation Agency, North Carolina Wildlife Resources Commission, Mine Safety and Health Administration, and Racing Reference, respectively. Confounder data from EPA’s Toxic Release Inventory, CDC’s Social Vulnerability Index, and the U.S. Census were linked using patient addresses. EPA’s National Emissions Inventory provided data on Pb emissions for certain businesses.
We identified 91 airports, 114 shooting ranges, 324 mines, and 44 racetracks in North Carolina. Of 9,864 patients (65% White, 23% Black, 11% Other) who did not move during the study period, 3,139 (32%) had an incident hypertension diagnosis (62% White, 31% Black, 6% Other). Planned Cox and random forest regressions will examine associations between hypertension and proximity to Pb-emitting sites, by sex, race, operation status, years of operation, and volume of operations or Pb emissions.