Estimating effects of ambient PM(2.5) exposure on health using PM(2.5) component measurements and regression calibration.

Most air pollution and health studies conducted in recent years have examined how a health outcome is related to pollution concentrations from a fixed outdoor monitor. The pollutant effect estimate in the health model used indicates how ambient pollution concentrations are associated with the health outcome, but not how actual exposure to ambient pollution is related to health. In this article, we propose a method of estimating personal exposures to ambient PM(2.5) (particulate matter less than 2.5 microm in diameter) using sulfate, a component of PM(2.5) that is derived primarily from ambient sources. We demonstrate how to use regression calibration in conjunction with these derived values to estimate the effects of personal ambient PM(2.5) exposure on a continuous health outcome, forced expiratory volume in 1 s (FEV(1)), using repeated measures data. Through simulation, we show that a confidence interval (CI) for the calibrated estimator based on large sample theory methods has an appropriate coverage rate. In an application using data from our health study involving children with moderate to severe asthma, we found that a 10 microg/m3 increase in PM(2.5) was associated with a 2.2% decrease in FEV(1) at a 1-day lag of the pollutant (95% CI: 0.0-4.3% decrease). Regressing FEV(1) directly on ambient PM(2.5) concentrations from a fixed monitor yielded a much weaker estimate of 1.0% (95% CI: 0.0-2.0% decrease). Relatively small amounts of personal monitor data were needed to calibrate the estimate based on fixed outdoor concentrations.