A multicity study of air pollution and cardiorespiratory emergency department visits: Comparing approaches for combining estimates across cities

Krall, JR; Chang, HH; Waller, LA; Mulholland, JA; Winquist, A; Talbott, EO; Rager, JR; Tolbert, PE; Sarnat, SE

HERO ID

6780094

Reference Type

Journal Article

Year

2018

Language

English

PMID

30107292

HERO ID 6780094
In Press No
Year 2018
Title A multicity study of air pollution and cardiorespiratory emergency department visits: Comparing approaches for combining estimates across cities
Authors Krall, JR; Chang, HH; Waller, LA; Mulholland, JA; Winquist, A; Talbott, EO; Rager, JR; Tolbert, PE; Sarnat, SE
Journal Environment International
Volume 120
Page Numbers 312-320
Abstract Determining how associations between ambient air pollution and health vary by specific outcome is important for developing public health interventions. We estimated associations between twelve ambient air pollutants of both primary (e.g. nitrogen oxides) and secondary (e.g. ozone and sulfate) origin and cardiorespiratory emergency department (ED) visits for 8 specific outcomes in five U.S. cities including Atlanta, GA; Birmingham, AL; Dallas, TX; Pittsburgh, PA; St. Louis, MO. For each city, we fitted overdispersed Poisson time-series models to estimate associations between each pollutant and specific outcome. To estimate multicity and posterior city-specific associations, we developed a Bayesian multicity multi-outcome (MCM) model that pools information across cities using data from all specific outcomes. We fitted single pollutant models as well as models with multipollutant components using a two-stage chemical mixtures approach. Posterior city-specific associations from the MCM models were somewhat attenuated, with smaller standard errors, compared to associations from time-series regression models. We found positive associations of both primary and secondary pollutants with respiratory disease ED visits. There was some indication that primary pollutants, particularly nitrogen oxides, were also associated with cardiovascular disease ED visits. Bayesian models can help to synthesize findings across multiple outcomes and cities by providing posterior city-specific associations building on variation and similarities across the multiple sources of available information.
Doi 10.1016/j.envint.2018.07.033
Pmid 30107292
Wosid WOS:000448688500032
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword Air pollution; Bayesian hierarchical models; Cardiorespiratory morbidity; Health associations; Time-series models
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