Christidis Tanya, Pinault Lauren L, Crouse Dan L, Tjepkema Michael
Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada.
Health Effects Institute, Boston, Massachusetts.
Environ Epidemiol. 2021 Dec 3;5(6):e180. doi: 10.1097/EE9.0000000000000180. eCollection 2021 Dec.
Associations between mortality and exposure to ambient air pollution are usually explored using concentrations of residential outdoor fine particulate matter (PM) to estimate individual exposure. Such studies all have an important limitation in that they do not capture data on individual mobility throughout the day to areas where concentrations may be substantially different, leading to possible exposure misclassification. We examine the possible role of outdoor PM concentrations at work for a large population-based mortality cohort.
Using the 2001 Canadian Census Health and Environment Cohort (CanCHEC), we created a time-weighted average that incorporates employment hours worked in the past week and outdoor PM concentration at work and home. We used a Cox proportional hazard model with a 15-year follow-up (2001 to 2016) to explore whether inclusion of workplace estimates had an impact on hazard ratios for mortality for this cohort.
Hazard ratios relying on outdoor PM concentration at home were not significantly different from those using a time-weighted estimate, for the full cohort, nor for those who commute to a regular workplace. When exploring cohort subgroups according to neighborhood type and commute distance, there was a notable but insignificant change in risk of nonaccidental death for those living in car-oriented neighborhoods, and with commutes greater than 10 km.
Risk analyses performed with large cohorts in low-pollution environments do not seem to be biased if relying solely on outdoor PM concentrations at home to estimate exposure.
死亡率与暴露于环境空气污染之间的关联通常通过住宅室外细颗粒物(PM)浓度来估计个体暴露情况进行探究。此类研究都存在一个重要局限性,即它们没有获取个体全天在不同区域活动的数据,而这些区域的污染物浓度可能存在显著差异,从而可能导致暴露误分类。我们研究了工作场所室外PM浓度对一个基于人群的大型死亡率队列的潜在作用。
利用2001年加拿大人口普查健康与环境队列(CanCHEC),我们创建了一个时间加权平均值,该值纳入了过去一周的工作时长以及工作场所和家中的室外PM浓度。我们使用Cox比例风险模型进行15年随访(2001年至2016年),以探究纳入工作场所估计值是否会对该队列的死亡率风险比产生影响。
对于整个队列以及那些通勤到固定工作场所的人来说,依赖家中室外PM浓度得出的风险比与使用时间加权估计值得出的风险比没有显著差异。在根据邻里类型和通勤距离对队列亚组进行探究时,对于居住在以汽车为主的邻里且通勤距离超过10公里的人,非意外死亡风险有显著但不显著的变化。
在低污染环境中对大型队列进行风险分析时,如果仅依靠家中室外PM浓度来估计暴露情况,似乎不会产生偏差。