Long-Term Exposure to Low-Level PM2.5 and Mortality: Investigation of Heterogeneity by Harmonizing Analyses in Large Cohort Studies in Canada, United States, and Europe
Jie Chen, Danielle Braun, Tanya Christidis, Michael A. Cork, Sophia Rodopoulou, Evangelia Samoli, Massimo Stafoggia, Kathrin Wolf, Xiao Wu, Weiran Yuchi, Zorana Jovanovic Andersen, Richard Atkinson, Mariska Bauwelinck, Kees de Hoogh, Nicole Janssen, Klea Katsouyanni, Jochem O. Klompmaker, Doris Tove Kristoffersen, Youn‐Hee Lim, Bente Oftedal, Maciej Strak, Danielle Vienneau, Jiawei Zhang, Richard T. Burnett, Gerard Hoek, Francesca Dominici, Michael Bräuer, Bert Brunekreef
Abstract
BACKGROUND: effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991-2016], the United States (Medicare, 2000-2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000-2016] as much as possible. METHODS: exposure estimates, and selected the same sets of potential confounders and the same outcome. We evaluated whether differences in previously published effect estimates across cohorts were reduced after harmonization among these factors. Additional analyses were conducted to assess the influence of key design features on estimated risks, including adjusted covariates and exposure assessment method. A combined CRF was assessed with meta-analysis based on the extended shape-constrained health impact function (eSCHIF). RESULTS: levels. A common CRF suggested a monotonically increased risk down to the lowest exposure level. https://doi.org/10.1289/EHP12141.