PROJECT SUMMARY/ABSTRACT
This application proposes improved exposure estimation approaches to wildfire smoke impacts to conduct better
epidemiologic assessment of kidney health risks, in the setting of a career development proposal. Dr. Jianzhao
Bi will create novel wildfire-derived PM2.5 (particulate matter < 2.5 µm in aerodynamic diameter) exposure
estimates with spatiotemporally complete coverage to characterize the effects of wildfire PM2.5 exposure on
individuals with or at risk of chronic kidney disease (CKD) and end-stage kidney disease (ESKD), a large
population extremely vulnerable to natural disasters, including wildfire smoke. Under the mentorship of Dr. Joel
Kaufman, this training and research plan will build upon Dr. Bi’s expertise in air pollution exposure and
epidemiology and prepare him for a career studying advanced analytic methods to understand environmental
exposures and their application in epidemiologic research. During the K99 phase, Dr. Bi will use didactic
instruction and independent study to gain additional training in 1) advanced data analysis and statistical methods
for “big data”, 2) analysis of PM2.5 speciation related to wildfire smoke, 3) epidemiologic analysis for long-term
air pollution exposure, 4) nephrotoxicity and mechanisms of PM2.5, and 5) electronic health data processing. This
training will provide Dr. Bi with interdisciplinary skills and knowledge as he moves toward an independent
research career in advanced environmental exposure and epidemiologic analyses. Dr. Bi’s research in the K99
phase aims to 1) develop innovative statistical prediction models to accurately separate wildfire PM2.5 from total
PM2.5 and 2) incorporate novel quantitative satellite and dense low-cost monitoring data into wildfire PM2.5
prediction. Dr. Bi’s wildfire PM2.5 models will require substantially fewer computational resources than chemical
transport models (CTMs), while producing exposure estimates expected to be more accurate than the estimates
derived by CTM and current statistical methods. During the R00 phase, Dr. Bi’s research focuses on assessing
1) chronic effects of multi-year wildfire PM2.5 exposure on individuals with or at risk of CKD and 2) acute effects
of multi-day wildfire PM2.5 exposure on ESKD patients receiving in-center hemodialysis (HD). His epidemiologic
analyses will rely on the Center for Kidney Disease Research, Education and Hope (CURE-CKD) registry with
individuals from inpatient, outpatient, and ambulatory settings following strict guideline-based CKD or at risk of
CKD criteria in the western U.S., and the United States Renal Data System (USRDS) with patient-level
demographics and dialysis/medical/mortality records on nearly all U.S. patients with ESKD receiving HD (with a
focus on the western U.S.). The R00 phase also examines effect modification by key variables and differences
in toxicity between wildfire and non-wildfire PM2.5. Dr. Bi’s epidemiologic studies will allow crucial new insights
into the concentration-response relationships between wildfire PM2.5 exposure and its effects on the vulnerable
kidney disease population. Better understanding the health impacts of wildfire smoke will facilitate more effective
smoke management decisions and policies, and in turn reduce the associated substantial health costs.