A Multipollutant Approach to Estimating Causal Effects of Air Pollution Mixtures on Overall Mortality in a Large, Prospective Cohort.


Journal

Epidemiology (Cambridge, Mass.)
ISSN: 1531-5487
Titre abrégé: Epidemiology
Pays: United States
ID NLM: 9009644

Informations de publication

Date de publication:
01 07 2022
Historique:
pubmed: 7 4 2022
medline: 3 6 2022
entrez: 6 4 2022
Statut: ppublish

Résumé

Several studies have confirmed associations between air pollution and overall mortality, but it is unclear to what extent these associations reflect causal relationships. Moreover, few studies to our knowledge have accounted for complex mixtures of air pollution. In this study, we evaluate the causal effects of a mixture of air pollutants on overall mortality in a large, prospective cohort of Dutch individuals. We evaluated 86,882 individuals from the LIFEWORK study, assessing overall mortality between 2013 and 2017 through national registry linkage. We predicted outdoor concentration of five air pollutants (PM2.5, PM10, NO2, PM2.5 absorbance, and oxidative potential) with land-use regression. We used logistic regression and mixture modeling (weighted quantile sum and boosted regression tree models) to identify potential confounders, assess pollutants' relevance in the mixture-outcome association, and investigate interactions and nonlinearities. Based on these results, we built a multivariate generalized propensity score model to estimate the causal effects of pollutant mixtures. Regression model results were influenced by multicollinearity. Weighted quantile sum and boosted regression tree models indicated that all components contributed to a positive linear association with the outcome, with PM2.5 being the most relevant contributor. In the multivariate propensity score model, PM2.5 (OR=1.18, 95% CI: 1.08-1.29) and PM10 (OR=1.02, 95% CI: 0.91-1.14) were associated with increased odds of mortality per interquartile range increase. Using novel methods for causal inference and mixture modeling in a large prospective cohort, this study strengthened the causal interpretation of air pollution effects on overall mortality, emphasizing the primary role of PM2.5 within the pollutant mixture.

Sections du résumé

BACKGROUND
Several studies have confirmed associations between air pollution and overall mortality, but it is unclear to what extent these associations reflect causal relationships. Moreover, few studies to our knowledge have accounted for complex mixtures of air pollution. In this study, we evaluate the causal effects of a mixture of air pollutants on overall mortality in a large, prospective cohort of Dutch individuals.
METHODS
We evaluated 86,882 individuals from the LIFEWORK study, assessing overall mortality between 2013 and 2017 through national registry linkage. We predicted outdoor concentration of five air pollutants (PM2.5, PM10, NO2, PM2.5 absorbance, and oxidative potential) with land-use regression. We used logistic regression and mixture modeling (weighted quantile sum and boosted regression tree models) to identify potential confounders, assess pollutants' relevance in the mixture-outcome association, and investigate interactions and nonlinearities. Based on these results, we built a multivariate generalized propensity score model to estimate the causal effects of pollutant mixtures.
RESULTS
Regression model results were influenced by multicollinearity. Weighted quantile sum and boosted regression tree models indicated that all components contributed to a positive linear association with the outcome, with PM2.5 being the most relevant contributor. In the multivariate propensity score model, PM2.5 (OR=1.18, 95% CI: 1.08-1.29) and PM10 (OR=1.02, 95% CI: 0.91-1.14) were associated with increased odds of mortality per interquartile range increase.
CONCLUSION
Using novel methods for causal inference and mixture modeling in a large prospective cohort, this study strengthened the causal interpretation of air pollution effects on overall mortality, emphasizing the primary role of PM2.5 within the pollutant mixture.

Identifiants

pubmed: 35384897
doi: 10.1097/EDE.0000000000001492
pii: 00001648-202207000-00009
pmc: PMC9148665
doi:

Substances chimiques

Air Pollutants 0
Particulate Matter 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

514-522

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

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Auteurs

Eugenio Traini (E)

From the Institute for Risk Assessment Sciences, Utrecht University, Utrecht.

Anke Huss (A)

From the Institute for Risk Assessment Sciences, Utrecht University, Utrecht.

Lützen Portengen (L)

From the Institute for Risk Assessment Sciences, Utrecht University, Utrecht.

Matti Rookus (M)

Department of Epidemiology, Netherlands Cancer Institute (NKI), Amsterdam.

W M Monique Verschuren (WMM)

Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Roel C H Vermeulen (RCH)

From the Institute for Risk Assessment Sciences, Utrecht University, Utrecht.

Andrea Bellavia (A)

From the Institute for Risk Assessment Sciences, Utrecht University, Utrecht.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.

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