“…After considering model fit (assessed via AIC) and considering biological factors that are known to be important, the tier two covariates were deemed to be most appropriate. Thus, in line with the previously published tier two framework (Nwanaji-Enwerem et al, 2016), the models for this analysis were adjusted for chronological age (continuous), six blood cell type estimates [ i.e . plasma cells, CD4+ lymphocytes, CD8+ lymphocytes, natural killer (NK) cells, monocytes, and granulocytes] (continuous) determined via Houseman and Horvath methods (Horvath, 2013; Houseman et al, 2012), average 1-year temperature (continuous), cumulative cigarette pack years (continuous), smoking status (current, former, or never), season of visit (spring [March–May], Summer [June–August], Fall [September–November], and Winter [December–February]), body mass index (BMI) (lean [<25], overweight (Horvath and Ritz, 2015; Levine et al, 2015a, 2015b, 2015c; Horvath et al, 2014; Horvath, 2013), obese [>30]), alcohol intake (yes/no ≥2 drinks daily), and maximum years of education (continuous).…”