Extended Analysis of Air Pollution and Cardiovascular Disease in the California Teachers Study Cohort FINAL REPORT Prepared for the California Environmental Protection Agency and the California Air Resources Board

ii Disclaimer The statements and conclusions in this Report are those of the contractor and not necessarily those of the California Air Resources Board. The mention of commercial products, their source, or their use in connection with material reported herein is not to be construed as actual or implied endorsement of such products. iii Acknowledgements The authors would like to thank Ms. Cynthia Garcia, Research Division, Air Resources Board (ARB), who not only served as the Project Manager for this investigation, but also generated and provided monthly pollutant averages and interpolated pollutant surfaces for use in exposure assessment. We would also like to acknowledge Drs. Rick Burnett and Edward Hughes for technical assistance. Finally, we would like to thank the California Teachers Study team, without whose efforts in assembling and maintaining the original cohort investigation this work would not have been possible. Table 13: Hazard ratios* for mortality and for incident MI and stroke in the California Teachers Study cohort, based on summer ozone interquartile ranges (1996 – 2005) ...... 36 Table 14: Hazard ratios for mortality and for incident MI and stroke, per 10 μg/m 3 increment of estimated long-term average PM2.5 for the California Teachers Study cohort (restricted to women who were post-menopausal at baseline). Table 15: Hazard ratios for mortality and for incident MI and stroke in relation to long-term pollutant exposures among the California Teachers Study cohort (restricted to women who were never-smokers at baseline). Table 18: Hazard ratios for ischemic heart disease (IHD) mortality in relation to long-term average pollution for the California Teachers Study, using two-pollutant models .. 44