Does consideration of larger study areas yield more accurate estimates of air pollution health effects? An illustration of the bias-variance trade-off in air pollution epidemiology

Pedersen, Marie; Siroux, Valérie; Pin, Isabelle; Munier, Charles; Forhan, Anne; Hulin, Agnès; Galineau, Julien; Lepeule, Johanna; Giorgis-Allemand, Lise; Sunyer, Jordi; Annesi‐Maesano, Isabella; Slama, Rémy

doi:10.1016/j.envint.2013.07.005

Cited by 16 publications

(10 citation statements)

References 41 publications

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“…However, circular buffers remain an appealing alternative when information on the population's use of the neighborhood is lacking, as in this study. Some studies have already looked at the impact of model scale on air pollution exposure assessment, showing either an impact (Pedersen et al, 2013), (Batterman et al, 2014) or an absence of impact (Stroh et al, 2007). To our knowledge, this study is the first to explore differential measurement errors resulting from the definition of the neighborhood, especially in the context of a medium-sized European city.…”

Section: Discussionmentioning

confidence: 90%

Air pollution in moderately polluted urban areas: How does the definition of “neighborhood” impact exposure assessment?

Tenailleau

Mauny

Joly

et al. 2015

Environmental Pollution

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Environmental health studies commonly quantify subjects' pollution exposure in their neighborhood. How this neighborhood is defined can vary, however, leading to different approaches to quantification whose impacts on exposure levels remain unclear. We explore the relationship between neighborhood definition and exposure assessment. NO2, benzene, PM10 and PM2.5 exposure estimates were computed in the vicinity of 10,825 buildings using twelve exposure assessment techniques reflecting different definitions of "neighborhood". At the city scale, its definition does not significantly influence exposure estimates. It does impact levels at the building scale, however: at least a quarter of the buildings' exposure estimates for a 400 m buffer differ from the estimated 50 m buffer value (±1.0 μg/m(3) for NO2, PM10 and PM2.5; and ±0.05 μg/m(3) for benzene). This variation is significantly related to the definition of neighborhood. It is vitally important for investigators to understand the impact of chosen assessment techniques on exposure estimates.

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Section: Discussionmentioning

confidence: 90%

Air pollution in moderately polluted urban areas: How does the definition of “neighborhood” impact exposure assessment?

Tenailleau

Mauny

Joly

et al. 2015

Environmental Pollution

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Section: The Potential For Confounding and Residual Confoundingmentioning

confidence: 99%

“…However, greater population heterogeneity may also increase the potential for confounding. 39 None of the large studies adjusted for type of area or other approaches to limit potential residual confounding because of area-associated factors.Finally, mutual adjustment for factors such as other air pollutants 3 and traffic-related noise, 40 which could influence the effect of exposure to air pollution over time and in space, were also rarely taken into account. It is impossible to rule out the possibility of residual confounding, given the limitations in many of the studies included in our meta-analysis.…”

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confidence: 99%

Ambient Air Pollution and Pregnancy-Induced Hypertensive Disorders

et al. 2014

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Gestational hypertension and preeclampsia are the most common complications of pregnancy affecting 2% to 10% of pregnancies after 20 weeks of pregnancy. 6,7 Gestational hypertension is usually diagnosed based on a systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg in previously normotensive women. 7 Preeclampsia is characterized by hypertension and protein in the urine. 6,8 In addition to maternal mortality, preeclampsia and related conditions are a leading cause of maternal morbidity, perinatal death, placental abruption, preterm birth, and child growth restriction. [6][7][8] The objective of this study was to systematically review epidemiological studies investigating associations between ambient air pollution and pregnancy-induced hypertensive disorders and to perform a meta-analysis of these studies.Abstract-Pregnancy-induced hypertensive disorders can lead to maternal and perinatal morbidity and mortality, but the cause of these conditions is not well understood. We have systematically reviewed and performed a meta-analysis of epidemiological studies investigating the association between exposure to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December 2009 and December 2013. Combined risk estimates were calculated using random-effect models for each exposure that had been examined in ≥4 studies. Heterogeneity and publication bias were evaluated. A total of 17 articles evaluating the impact of nitrogen oxides (NO 2 , NO X ), particulate matter (PM 10 , PM 2.5 ), carbon monoxide (CO), ozone (O 3 ), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Metaanalyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta-analysis combined odds ratio associated with a 5-µg/m 3 increase in PM 2.5 was 1.57 (95% confidence interval, 1.26-1.96) for combined pregnancy-induced hypertensive disorders and 1.31 (95% confidence interval, 1.14-1.50) for preeclampsia. Our results suggest that exposure to air pollution increases the risk of pregnancy-induced hypertensive (Figure 1). A total of 17 studies were considered relevant to be included in the systematic review and meta-analysis. If not reported, we requested from the authors effect estimates for continuous exposure. Additional unpublished information was received for a Swedish study, 9 which was included in our analyses. We excluded 1 small (n=2707) stu...

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“…This potential for bias likely increases with the size of the study area, since large areas are generally more socially diverse; studies in large areas allow considering a large sample size and increasing exposure contrasts, but are also more likely to suffer from confounding by SES and behaviours. This can be seen as a manifestation of the so-called bias-variance tension 42. Thus, the larger is not always the better.…”

Section: Discussionmentioning

confidence: 99%

Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France

Ouidir

Lepeule

Siroux

et al. 2017

J Epidemiol Community Health

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We highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhoods were those most exposed to health-threatening atmospheric pollutants.

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Does consideration of larger study areas yield more accurate estimates of air pollution health effects? An illustration of the bias-variance trade-off in air pollution epidemiology

Cited by 16 publications

References 41 publications

Air pollution in moderately polluted urban areas: How does the definition of “neighborhood” impact exposure assessment?

Air pollution in moderately polluted urban areas: How does the definition of “neighborhood” impact exposure assessment?

Ambient Air Pollution and Pregnancy-Induced Hypertensive Disorders

Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France

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