Relating Ambient Particulate Matter Concentration Levels to Mortality Using an Exposure Simulator.

Since the U.S. Environmental Protection Agency began widespread monitoring of PM2.5 (particulate matter <2.5 p in diameter) concentration levels in the late 1990s, the epidemiological community has performed several observational studies directly relating PM2.5 concentration to various health endpoints including mortality and morbidity. However, recent research suggests that human exposure to the constituents of PM2.5 may differ significantly from ambient (or outdoor) PM2.5 concentration measured by monitors because people spend a great deal of time in environments, such as various indoor environments, where they are partially shielded from ambient sources of PM and are exposed to nonambient sources of PM. Recent research has provided some ways to include exposure information, but little has been done to determine the impact of including such information in a statistical model. To address this concern, we develop a three-stage Bayesian hierarchical model based on the Poisson regression model that is traditionally used to characterize the relationship between PM2.5 concentration and health endpoints. Our approach includes a spatial model relating monitor readings to average county PM2.5 concentration and an exposure simulator that links average ambient PM2.5 concentration to average personal exposure using activity pattern data. We apply our model to a study population in North Carolina and explore the impact of various exposure modeling assumptions on the conclusions that can be drawn about the link between PM2.5 exposure and cardiovascular mortality. [ABSTRACT FROM AUTHOR]