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dc.contributor.authorChen, Jie
dc.contributor.authorBraun, Danielle
dc.contributor.authorChristidis, Tanya
dc.contributor.authorCork, Michael
dc.contributor.authorRodopoulou, Sophia
dc.contributor.authorSamoli, Evangelia
dc.contributor.authorStafoggia, Massimo
dc.contributor.authorWolf, Kathrin
dc.contributor.authorWu, Xiao
dc.contributor.authorYuchi, Weiran
dc.contributor.authorAndersen, Zorana J.
dc.contributor.authorAtkinson, Richard
dc.contributor.authorBauwelinck, Mariska
dc.contributor.authorde Hoogh, Kees
dc.contributor.authorJanssen, Nicole A H
dc.contributor.authorKatsouyanni, Klea
dc.contributor.authorKlompmaker, Jochem O.
dc.contributor.authorKristoffersen, Doris Tove
dc.contributor.authorLim, Youn-Hee
dc.contributor.authorOftedal, Bente Margaret
dc.contributor.authorStrak, Maciej
dc.contributor.authorVienneau, Danielle
dc.contributor.authorZhang, Jiawei
dc.contributor.authorBurnett, Richard T.
dc.contributor.authorHoek, Gerard
dc.contributor.authorDominici, Francesca
dc.contributor.authorBrauer, Michael
dc.contributor.authorBrunekreef, Bert
dc.date.accessioned2024-02-14T13:21:35Z
dc.date.available2024-02-14T13:21:35Z
dc.date.issued2023-12-01
dc.description.abstractBackground: Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter ≤ 2,5 μm (PM<sub>2,5</sub>) exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design factors (including confounders, applied exposure model, population age, and outcome definition) on (PM<sub>2,5</sub> effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991–2016], the United States (Medicare, 2000–2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000–2016] as much as possible.<p> <p>Methods: We harmonized the study populations to individuals 65 + years of age, applied the same satellite-derived PM<sub>2,5</sub> exposure estimates, and selected the same sets of potential confounders and the same outcome. We evaluated whether differences in previously published effect estimates across cohorts were reduced after harmonization among these factors. Additional analyses were conducted to assess the influence of key design features on estimated risks, including adjusted covariates and exposure assessment method. A combined CRF was assessed with meta-analysis based on the extended shape-constrained health impact function (eSCHIF).<p> <p>Results: More than 81 million participants were included, contributing 692 million person-years of follow-up. Hazard ratios and 95% confidence intervals (CIs) for all-cause mortality associated with a 5-μg/m<sup>3</sup> increase in PM<sub>2,5</sub> were 1.039 (1.032, 1.046) in MAPLE, 1.025 (1.021, 1.029) in Medicare, and 1.041 (1.014, 1.069) in ELAPSE. Applying a harmonized analytical approach marginally reduced difference in the observed associations across the three studies. Magnitude of the association was affected by the adjusted covariates, exposure assessment methodology, age of the population, and marginally by outcome definition. Shape of the CRFs differed across cohorts but generally showed associations down to the lowest observed PM<sub>2,5</sub> levels. A common CRF suggested a monotonically increased risk down to the lowest exposure level.en_US
dc.identifier.citationChen, Braun, Christidis, Cork, Rodopoulou, Samoli, Stafoggia, Wolf, Wu, Yuchi, Andersen, Atkinson, Bauwelinck, de Hoogh, Janssen, Katsouyanni, Klompmaker, Kristoffersen, Lim, Oftedal, Strak, Vienneau, Zhang, Burnett, Hoek, Dominici, Brauer, Brunekreef. Long-Term Exposure to Low-Level formula PM2.5 and Mortality: Investigation of Heterogeneity by Harmonizing Analyses in Large Cohort Studies in Canada, United States, and Europe. Environmental Health Perspectives. 2023;131(12):1-13en_US
dc.identifier.cristinIDFRIDAID 2216144
dc.identifier.doi10.1289/EHP12141
dc.identifier.issn0091-6765
dc.identifier.issn1552-9924
dc.identifier.urihttps://hdl.handle.net/10037/32931
dc.language.isoengen_US
dc.publisherEHP Publishingen_US
dc.relation.journalEnvironmental Health Perspectives
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleLong-Term Exposure to Low-Level formula PM2.5 and Mortality: Investigation of Heterogeneity by Harmonizing Analyses in Large Cohort Studies in Canada, United States, and Europeen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)