Environmental predictors of survival in a cohort of U.S. military veterans: A multi-level spatio-temporal analysis stratified by race

Lipfert, Frederick W.; Wyzga, Ronald E.

doi:10.1016/j.envres.2019.108842

Cited by 6 publications

(16 citation statements)

References 73 publications

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“…A real difference, but not as large as one might have expected. It is worth noting that, while analyses of the nationwide ACS cohort have consistently reported significant mortality effects of PM2.5, more recent analyses of a cohort of 70,000 male veterans did not (Lipfert & Wyzga, 2018, 2020).…”

Section: Overall Findings and Discussionmentioning

confidence: 98%

Long‐Term Effects of Fine Particles on Mortality: Insights from 1984

Kinney

2021

Risk Analysis

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I review an important study that Professor Evans published early in his career examining the role of cross‐sectional mortality studies in air pollution risk assessment. At a time when both risk assessment and particle effects on mortality were controversial, John's thoughtful analysis of the issues and data relevant to assessing long‐term mortality risks from airborne particles provides a comprehensive primer that is still relevant today. The paper includes a critical literature review, a meta‐analysis of published particle effect estimates, and a reanalysis of landmark cross‐sectional mortality data set. EPA criteria documents and related literature had largely discounted the cross‐sectional mortality findings on the basis of criticisms about exposure assessment and control for confounding. John's analysis reached a different conclusion, that is, “we are of the opinion that the cross‐sectional studies reflect a causal relationship between exposure to airborne particles and premature mortality. From our point of view it is as likely that parameters have been underestimated … as that they are overestimated due to confounding.” The paper acknowledged the impossibility of precisely quantifying the long‐term mortality effect of particle air pollution, and that there is a need for further research utilizing alternative approaches. These conclusions foreshadow the emergence, a decade later, of the influential particulate matter (PM) mortality findings from the Harvard Six Cities and American Cancer Society cohort studies. I conclude by suggesting that well designed cross‐sectional studies could play a role in identifying exposure–response associations in resource‐poor settings where there is a paucity of local evidence to support air pollution regulations.

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Section: Overall Findings and Discussionmentioning

confidence: 98%

Long‐Term Effects of Fine Particles on Mortality: Insights from 1984

Kinney

2021

Risk Analysis

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“…Many air pollution epidemiology studies have been designed to test the hypothesis that a designated pollutant is associated with one or more health conditions. The Veterans Cohort Study considered 36 air pollutants including PM 2.5 constituents as alternative predictors of a single end point (all-cause mortality [5][6][7][8][9]. Five pollutants (vanadium, nickel, elemental carbon, nitrate ion, and traffic density) were highly statistically significant (0.005 < p < 0.025), with mean effects from 0.04 to 0.14, but a public health official would need to know which of them might be the most important.…”

Section: Multiple Pollutant Modelingmentioning

confidence: 99%

“…I used 2-and 3-pollutant regression models to address this question as shown in Figure 1, which shows reductions in mean effects estimated from joint multiple-pollutant regressions relative to the sums of single pollutant estimates, comprising 22% with 2-pollutant models and 36% with 3-pollutant models. [5][6][7][8][9]. Five pollutants (vanadium, nickel, elemental carbon, nitrate ion, and traffic density) were highly statistically significant (0.005 < p < 0.025), with mean effects from 0.04 to 0.14, but a public health official would need to know which of them might be the most important.…”

Section: Multiple Pollutant Modelingmentioning

confidence: 99%

“…Peak ozone shows increasing risks with more recent exposures and 1997 traffic density poses the same risk for all mortality periods. PM 2.5 risks in this dataset are sensitive to race [8] and thus were not included here. The common characteristic in Table 3 is that of uniformity in the estimated risks among pollutants and over both exposure and mortality timing; the overall mean risk was 1.047 [1.028-1.067].…”

Section: Exposure Issues With Long-term Studiesmentioning

confidence: 99%

“…Exposure data comprised the complete suite of regulated air pollutants from 1960 onward, and the study design included long-term lags. Subsequent papers considered traffic density [6], pollutant modeling [7], and separate analyses by race [8] and by age [9]. These analyses included individual data on blood pressure and ecological data on climate and census tract characteristics.…”

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confidence: 99%

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Air Pollution and Mortality: Timing Is Everything

Lipfert¹

2020

Atmosphere

Self Cite

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This paper considers timing issues in health-effect exposure and response studies. Short-term studies must consider delayed and cumulative responses; prior exposures, disease latency, and cumulative impacts are required for long-term studies. Lacking individual data, long-term air quality describes locations, as do greenspaces and traffic density, rather than exposures of residents. Indoor air pollution can bias long-term exposures and effect estimates but short-term effects also respond to infiltrated outdoor air. Daily air quality fluctuations may affect the frail elderly and are necessarily included in long-term averages; any true long-term effects must be given by differences between annual and daily effects. I found such differences to be negligible after adjusting for insufficient lag effects in time-series studies and neglect of prior exposures in long-term studies. Aging of subjects under study implies cumulative exposures, but based on age-specific mortality, I found relative risks decreasing with age, precluding cumulative effects. A new type of time-series study found daily mortality of previously frail subjects to be associated with various pollutants without exposure thresholds, but the role of air pollution in the onset of frailty remains an unexplored issue. The importance of short-term fluctuations has been underestimated and putative effects of long-term exposures have been overestimated.

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Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

Casey,

Daouda,

Babadi

et al. 2023

Curr Envir Health Rpt

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Purpose of Review The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. Recent Findings We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Summary Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.

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Environmental predictors of survival in a cohort of U.S. military veterans: A multi-level spatio-temporal analysis stratified by race

Cited by 6 publications

References 73 publications

Long‐Term Effects of Fine Particles on Mortality: Insights from 1984

Long‐Term Effects of Fine Particles on Mortality: Insights from 1984

Air Pollution and Mortality: Timing Is Everything

Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

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