To evaluate the validity of fixed-site fine particle levels as exposure surrogates in air pollution epidemiology, we considered four indicator groups: (1) PM 2.5 total mass concentrations, (2) sulfur and potassium for regional air pollution, (3) lead and bromine for traffic-related particles, and (4) calcium for crustal particles. Using data from the European EXPOLIS (Air Pollution Exposure Distribution within Adult Urban Populations in Europe) study, we assessed the associations between 48-hr personal exposures and home outdoor levels of the indicators. Furthermore, within-city variability of fine particle levels was evaluated.Personal exposures to PM 2.5 mass were not correlated to corresponding home outdoor levels (n = 44, r Spearman (Sp) = 0.07). In the group reporting neither relevant indoor sources nor relevant activities, personal exposures and home outdoor levels of sulfur were highly correlated (n = 40, r Sp = 0.85). In contrast, the associations were weaker IMPLICATIONS Accurate exposure assessment is a key step when investigating the effects of ambient air pollution and the related public health impact. In cross-sectional analysis, we could show that 48-hr personal exposure to PM 2.5 -sulfur, indicating regional air pollution, is highly correlated to corresponding outdoor PM 2.5 -sulfur levels. For indicators of traffic-related and crustal particles, the associations were weaker. We conclude that epidemiologic studies on long-term effects of air pollution may rely on fixed-site fine particle mass to estimate exposures to regional air pollution. For exposures to primary traffic particles, where spatial variability and proximity to the source are important factors, estimates may be improved with data on traffic exposures.for traffic (Pb: n = 44, r Sp = 0.53; Br: n = 44, r Sp = 0.21) and crustal (Ca: n = 44, r Sp = 0.12) indicators. This contrast is consistent with spatially homogeneous regional pollution and higher spatial variability of traffic and crustal indicators observed in Basel, Switzerland.We conclude that for regional air pollution, fixed-site fine particle levels are valid exposure surrogates. For sourcespecific exposures, however, fixed-site data are probably not the optimal measure. Still, in air pollution epidemiology, ambient PM 2.5 levels may be more appropriate exposure estimates than total personal PM 2.5 exposure, since the latter reflects a mixture of indoor and outdoor sources.
INTRODUCTIONEpidemiologic studies conducted in a variety of regions and populations indicate consistent associations between ambient levels of air pollution and health outcomes. Respiratory symptoms, lung function, and mortality have been observed to be related to both short-term 1,2 and longterm exposures.2,3 Long-term effects of ambient air pollution are often investigated in semi-individual studies.