© 1998 Oxford University Press
research-article |
Inappropriate use of daily mortality analyses to estimate longer-term mortality effects of air pollution
aDepartment of Epidemiology and Population Health. London School of Hygiene and Tropical Medicine Keppel Street, London WCIE 7HT. UK
bDepartment of Public Health Science, St George's Hospital Medical School Cranmer Terrace, London SW17 ORE, UX
cDepartment of Epidemiology and Public Health, University of Wagenrngen Po Box 238, 6700 AB Wageningen, The Netherlands
dHealth Effects Institute 955 Massachusetts Avenue, Boston, MA 02139. USA
BACKGROUND: To avoid the usual problems of multi-population correlation studies of air poilution and mortality, and for reasons of convenience, daily time-series mortality studies within single populations have recently become popular in air pollution epidemiology. Such studies describe how the short-term distribution of deaths relates to short-term fluctuations in air pollution levels. The regression-based risk coefficients from these acute-effects studies have been widely used to estimate the excess annual mortality within a population with a specified average level of air pollution. Such calculations are inappropriate. Smce daily time-series data provide no simple direct information about the degree of life-shortening associated with the excess daily deaths (many of which are thought to be due to exacerbation of well-advanced disease, especially cardiovascular disease), such data cannot contribute to the estimation of the effects of air pollution upon chronic disease incidence and long-term death rates. Yet it is that category of effect that is of most public health importance.
CONCLUSIONS: Such effects are best estimated from long-term cohort studies that incorporate good knowledge of local (or personal) exposure to air pollutants and of potential confounders. Time-series studies, properly evaluated, can identify the existence of acute toxic effects of transient peak levels of air pollution; they are thus useful for monitoring acute toxicity and for identifying the most noxious pollutants. However, to quantify the long-term health impacts of air pollution we cannot use acute-effects data.
Keywords Air pollution, mortality, study design, time-series data, acute effects, chronic effects
Accepted 16 September 1997
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Elliott, G. Shaddick, J. C Wakefield, C. d. Hoogh, and D. J Briggs Long-term associations of outdoor air pollution with mortality in Great Britain Thorax, December 1, 2007; 62(12): 1088 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O.P. Kurmi and J.G. Ayres Review Series: Occupational and environmental lung disease: The non-occupational environment and the lung: opportunities for intervention Chronic Respiratory Disease, November 1, 2007; 4(4): 227 - 236. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Hales and P. Howden-Chapman Effects of air pollution on health BMJ, August 18, 2007; 335(7615): 314 - 315. [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Miller, D. S. Siscovick, L. Sheppard, K. Shepherd, J. H. Sullivan, G. L. Anderson, and J. D. Kaufman Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women N. Engl. J. Med., February 1, 2007; 356(5): 447 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Finkelstein, M. Jerrett, and M. R. Sears Traffic Air Pollution and Mortality Rate Advancement Periods Am. J. Epidemiol., July 15, 2004; 160(2): 173 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Mindell and M Joffe Predicted health impacts of urban air quality management J Epidemiol Community Health, February 1, 2004; 58(2): 103 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.R. Anderson, R.W. Atkinson, S.A. Bremner, and L. Marston Particulate air pollution and hospital admissions for cardiorespiratory diseases: are the elderly at greater risk? Eur. Respir. J., May 1, 2003; 21(40_suppl): 39S - 46s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Martuzzi, M. Krzyzanowski, and R. Bertollini Health impact assessment of air pollution: providing further evidence for public health action Eur. Respir. J., May 1, 2003; 21(40_suppl): 86S - 91s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Sandstrom, A.J. Frew, M. Svartengren, and G. Viegi The need for a focus on air pollution research in the elderly Eur. Respir. J., May 1, 2003; 21(40_suppl): 92S - 95s. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Krzyzanowski, A Cohen, and R Anderson Quantification of health effects of exposure to air pollution Occup. Environ. Med., December 1, 2002; 59(12): 791 - 793. [Full Text] [PDF]
|
|
|
|
|
|
M Joffe and J Mindell A framework for the evidence base to support Health Impact Assessment J Epidemiol Community Health, February 1, 2002; 56(2): 132 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. ATKINSON, H. ROSS ANDERSON, J. SUNYER, J. AYRES, M. BACCINI, J. M. VONK, A. BOUMGHAR, F. FORASTIERE, B. FORSBERG, G. TOULOUMI, et al. Acute Effects of Particulate Air Pollution on Respiratory Admissions . Results from APHEA 2 Project Am. J. Respir. Crit. Care Med., November 15, 2001; 164(10): 1860 - 1866. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Martuzzi, N. Kunzli, R. Kaiser, and S. Medina RE: "ASSESSMENT OF DEATHS ATTRIBUTABLE TO AIR POLLUTION: SHOULD WE USE RISK ESTIMATES BASED ON TIME SERIES OR ON COHORT STUDIES?" Am. J. Epidemiol., November 15, 2001; 154(10): 974 - 975. [Full Text] [PDF]
|
|
|
|
|
|
N. Kunzli, S. Medina, R. Kaiser, P. Quenel, F. Horak Jr., and M. Studnicka Assessment of Deaths Attributable to Air Pollution: Should We Use Risk Estimates based on Time Series or on Cohort Studies? Am. J. Epidemiol., June 1, 2001; 153(11): 1050 - 1055. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. R. Smith Inaugural Article: National burden of disease in India from indoor air pollution PNAS, November 21, 2000; 97(24): 13286 - 13293. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Haines, T. McMichael, R. Anderson, and J. Houghton Fossil fuels, transport, and public health BMJ, November 11, 2000; 321(7270): 1168 - 1169. [Full Text]
|
|