title: Panel discussion review: session two--interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses.
abstract: Air pollution epidemiologic research has often utilized ambient air concentrations measured from centrally located monitors as a surrogate measure of exposure to these pollutants. Associations between these ambient concentrations and health outcomes such as lung function, hospital admissions, and mortality have been examined in short- and long-term cohort studies as well as in time-series and case-crossover studies. The issues related to interpreting the observed associations of ambient air pollutants with health outcomes were discussed at the US EPA sponsored workshop on December 13 and 14, 2006 in Chapel Hill, North Carolina, USA. The second session of this workshop focused on the following topics: (1) statistical methodology and study designs that may improve understanding of multipollutant health effects; (2) ambient concentrations as surrogate measures of pollutant mixtures; and (3) source-focused epidemiologic research. New methodology and approaches to better distinguish the effects of individual pollutants include multicity hierarchical modeling and the use of case-crossover analysis to control for copollutants. An alternative approach is to examine the mixture as a whole using principal component analysis. Another important consideration is to what extent the observed health associations are attributable to individual pollutants, which are often from common sources and are correlated, versus the pollutant mixtures that the pollutants are representing. For example, several ambient air concentrations, such as particulate matter mass, nitrogen dioxide, and carbon monoxide, may be serving as surrogate measures of motor vehicle exhaust. Source apportionment analysis is one method that may allow further advancement in understanding the source components that contribute to multipollutant health effects.
authors: National Center for Environmental Assessment, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA. kim.jee-young@epa.gov
authors: Jee Young
authors: JY
authors: Kim
authors: Richard T
authors: RT
authors: Burnett
authors: Lucas
authors: L
authors: Neas
authors: George D
authors: GD
authors: Thurston
authors: Joel
authors: J
authors: Schwartz
authors: Paige E
authors: PE
authors: Tolbert
authors: Bert
authors: B
authors: Brunekreef
authors: Mark S
authors: MS
authors: Goldberg
authors: Isabelle
authors: I
authors: Romieu
mesh_terms: D000393:Air Pollutants / Q000032:analysis* / Q000633:toxicity; D015331:Cohort Studies; D018592:Cross-Over Studies; D003627:Data Interpretation, Statistical; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D004782:Environmental Health; D016021:Epidemiologic Studies; D006801:Humans; D009657:North Carolina; D052638:Particulate Matter / Q000032:analysis* / Q000633:toxicity; D018570:Risk Assessment / Q000379:methods; D014481:United States; D014484:United States Environmental Protection Agency
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter