Advertisement Banner
Skip to content


Research Article Advance Publication

Environ Health Perspect; DOI:10.1289/ehp.1307772

An Empirical Assessment of Exposure Measurement Error and Effect Attenuation in Bipollutant Epidemiologic Models

Kathie L. Dionisio,1 Lisa K. Baxter,1 and Howard H. Chang
Author Affiliations close
1National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA; 2Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
About This Article open

This EHP Advance Publication article has been peer-reviewed, revised, and accepted for publication. EHP Advance Publication articles are completely citable using the DOI number assigned to the article. This document will be replaced with the copyedited and formatted version as soon as it is available. Through the DOI number used in the citation, you will be able to access this document at each stage of the publication process.

Citation: Dionisio KL, Baxter LK, Chang HH. An Empirical Assessment of Exposure Measurement Error and Effect Attenuation in Bipollutant Epidemiologic Models. Environ Health Perspect;

Received: 21 October 2013
Accepted: 3 July 2014
Advance Publication: 8 July 2014

Accessible PDF icon PDF Version (3.1 MB) | Accessible PDF icon Supplemental Material (952 KB)


Background: Using multipollutant models to understand combined health effects of exposure to multiple pollutants is becoming more common. However, complex relationships between pollutants and differing degrees of exposure error across pollutants can make health effect estimates from multipollutant models difficult to interpret.

Objectives: To quantify relationships between multiple pollutants and their associated exposure errors across metrics of exposure, and use empirical values to evaluate potential attenuation of coefficients in epidemiologic models.

Methods: We used three daily exposure metrics (central-site measurements, air quality model estimates, population exposure model estimates) for 193 ZIP codes in the Atlanta, Georgia metropolitan area, from 1999-2002, for PM2.5 and its components (EC, SO4), O3, CO, and NOx, to construct three types of exposure error: δspatial (comparing air quality model estimates to central-site measurements), δpopulation (comparing population exposure model estimates to air quality model estimates), and δtotal (comparing population exposure model estimates to central-site measurements). We compared exposure metrics and exposure errors within and across pollutants, and present derived attenuation factors (ratio of observed to true coefficient for pollutant of interest) for single and bipollutant model coefficients.

Results: Pollutant concentrations and their exposure errors were moderately to highly correlated (typically > 0.5), especially for CO, NOx, and EC (i.e., “local” pollutants); correlations differed across exposure metrics and types of exposure error. Spatial variability was evident, with variance of exposure error for local pollutants ranging from 0.25–0.83 for δspatial and δtotal. The attenuation of model coefficients in single and bipollutant epidemiologic models relative to the true value differed across types of exposure error, pollutants, and space.

Conclusions: Under a classical exposure error framework, attenuation may be substantial for local pollutants due to δspatial and δtotal, with true coefficients reduced by a factor typically < 0.6 (results vary for δpopulation and regional pollutants).

WP-Backgrounds Lite by InoPlugs Web Design and Juwelier Schönmann 1010 Wien