Cox Louis Anthony
Cox Associates, Entanglement, University of Colorado at Denver, Denver, Colorado, USA.
Glob Epidemiol. 2024 Aug 21;8:100160. doi: 10.1016/j.gloepi.2024.100160. eCollection 2024 Dec.
The use of unverified models for risk estimates and policy recommendations can be highly misleading, as their predictions may not reflect real-world health impacts. For example, a recent article states that NO from gas stoves "likely causes ∼50,000 cases of current pediatric asthma from long-term NO exposure alone" annually in the United States. This explicitly causal claim, which is contrary to several methodology and review articles published in this journal, among others, reflects both (a) An unverified modeling assumption that pediatric asthma burden is approximately proportional to NO; and (b) An unverified causal assumption that the assumed proportionality between exposure and response is causal. The article is devoid of any causal analysis showing that these assumptions are likely to be true. It does not show that reducing NO exposure from gas stoves would reduce pediatric asthma risk. Its key references report no significant associations - let alone causation - between NO and pediatric asthma. Thus, the underlying data suggests that the number of pediatric asthma cases caused by gas stoves in the United States is indistinguishable from zero. This highlights the need to rigorously validate modeling assumptions and causal claims in public health risk assessments to ensure scientifically sound foundations for policy decisions.
使用未经验证的模型进行风险评估和政策建议可能会产生极大的误导,因为它们的预测可能无法反映现实世界中的健康影响。例如,最近一篇文章称,仅在美国,燃气灶具产生的一氧化氮“每年可能仅因长期接触一氧化氮就导致约5万例儿童哮喘病例”。这一明确的因果关系主张与本期刊及其他刊物发表的几篇方法学和综述文章相悖,它既反映了:(a)一个未经验证的建模假设,即儿童哮喘负担与一氧化氮大致成正比;(b)一个未经验证的因果假设,即假设的暴露与反应之间的比例关系是因果关系。该文章没有任何因果分析表明这些假设可能是正确的。它没有表明减少燃气灶具产生的一氧化氮暴露会降低儿童哮喘风险。其关键参考文献并未报告一氧化氮与儿童哮喘之间存在显著关联——更不用说因果关系了。因此,基础数据表明,美国由燃气灶具导致的儿童哮喘病例数与零无异。这凸显了在公共卫生风险评估中严格验证建模假设和因果关系主张的必要性,以确保政策决策有科学可靠的基础。