Air Pollution and Mortality: Timing Is Everything

This paper considers timing issues in health-effect exposure and response studies. Short-term studies must consider delayed and cumulative responses; prior exposures, disease latency, and cumulative impacts are required for long-term studies. Lacking individual data, long-term air quality describes...

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Main Author: Frederick W. Lipfert
Format: Article
Language:English
Published: MDPI AG 2020-11-01
Series:Atmosphere
Subjects:
Online Access:https://www.mdpi.com/2073-4433/11/12/1274
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author Frederick W. Lipfert
author_facet Frederick W. Lipfert
author_sort Frederick W. Lipfert
collection DOAJ
description This paper considers timing issues in health-effect exposure and response studies. Short-term studies must consider delayed and cumulative responses; prior exposures, disease latency, and cumulative impacts are required for long-term studies. Lacking individual data, long-term air quality describes locations, as do greenspaces and traffic density, rather than exposures of residents. Indoor air pollution can bias long-term exposures and effect estimates but short-term effects also respond to infiltrated outdoor air. Daily air quality fluctuations may affect the frail elderly and are necessarily included in long-term averages; any true long-term effects must be given by differences between annual and daily effects. I found such differences to be negligible after adjusting for insufficient lag effects in time-series studies and neglect of prior exposures in long-term studies. Aging of subjects under study implies cumulative exposures, but based on age-specific mortality, I found relative risks decreasing with age, precluding cumulative effects. A new type of time-series study found daily mortality of previously frail subjects to be associated with various pollutants without exposure thresholds, but the role of air pollution in the onset of frailty remains an unexplored issue. The importance of short-term fluctuations has been underestimated and putative effects of long-term exposures have been overestimated.
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spelling doaj.art-9e89f0a757034896acb1b69b3ced30cc2023-11-20T22:19:47ZengMDPI AGAtmosphere2073-44332020-11-011112127410.3390/atmos11121274Air Pollution and Mortality: Timing Is EverythingFrederick W. Lipfert0Independent Consultant, 1500 Brecknock Rd., Greenport, NY 11944, USAThis paper considers timing issues in health-effect exposure and response studies. Short-term studies must consider delayed and cumulative responses; prior exposures, disease latency, and cumulative impacts are required for long-term studies. Lacking individual data, long-term air quality describes locations, as do greenspaces and traffic density, rather than exposures of residents. Indoor air pollution can bias long-term exposures and effect estimates but short-term effects also respond to infiltrated outdoor air. Daily air quality fluctuations may affect the frail elderly and are necessarily included in long-term averages; any true long-term effects must be given by differences between annual and daily effects. I found such differences to be negligible after adjusting for insufficient lag effects in time-series studies and neglect of prior exposures in long-term studies. Aging of subjects under study implies cumulative exposures, but based on age-specific mortality, I found relative risks decreasing with age, precluding cumulative effects. A new type of time-series study found daily mortality of previously frail subjects to be associated with various pollutants without exposure thresholds, but the role of air pollution in the onset of frailty remains an unexplored issue. The importance of short-term fluctuations has been underestimated and putative effects of long-term exposures have been overestimated.https://www.mdpi.com/2073-4433/11/12/1274air pollutionmortalitytime seriescohortindoor airage specific
spellingShingle Frederick W. Lipfert
Air Pollution and Mortality: Timing Is Everything
Atmosphere
air pollution
mortality
time series
cohort
indoor air
age specific
title Air Pollution and Mortality: Timing Is Everything
title_full Air Pollution and Mortality: Timing Is Everything
title_fullStr Air Pollution and Mortality: Timing Is Everything
title_full_unstemmed Air Pollution and Mortality: Timing Is Everything
title_short Air Pollution and Mortality: Timing Is Everything
title_sort air pollution and mortality timing is everything
topic air pollution
mortality
time series
cohort
indoor air
age specific
url https://www.mdpi.com/2073-4433/11/12/1274
work_keys_str_mv AT frederickwlipfert airpollutionandmortalitytimingiseverything