Association of indoor nitrogen dioxide with respiratory symptoms in children: Application of measurement error correction techniques to utilize data from multiple surrogates
Association of indoor nitrogen dioxide with respiratory symptoms in children: Application of measurement error correction techniques to utilize data from multiple surrogates
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DOI：
10.1038/sj.jes.7500468
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发表时间：
2006-07-01
影响因子：
4.5
通讯作者：
Spiegelman, Donna
中科院分区：
文献类型：
--
作者：
Li, Ruifeng;Weller, Edie;Spiegelman, Donna
1991年，Neas等人报道了高温燃烧的副产物室内二氧化氮（NO2）与1983年至1988年在美国6个城市研究的1159名7-11岁白人儿童的下呼吸道症状显著相关。NO2每增加15ppb，多因素校正优势比（OR）为1.4（95%可信区间(CI) =[1.1,1.7]）。虽然仅对一部分儿童进行了室内环境空气中NO2浓度的评估，但在室内监测项目进行时，所有儿童的下呼吸道症状患病率和替代暴露变量均可获得。本研究采用回归校准方法，评估室内NO2暴露对下呼吸道症状年风险的影响。该研究共有2891名儿童，具有完整的共变量和结局数据，其中1137名儿童直接测量了NO2, 1754名儿童只有替代暴露数据。对室内年NO2暴露效应（p.p.b.）进行了估计，并对1754个NO2替代源的使用引起的测量误差进行了调整。这些来源包括是否存在带或不带指示灯的煤气灶，是否存在煤油空间加热器，是否存在木灶，以及炉子的使用情况，以及住宅特征，包括厨房通风的风扇使用情况和家中房间的总数。在调整了年龄、性别、城市、父母呼吸道疾病史和儿童家中吸烟（包/天）等因素后，儿童的吸烟率为15%。二氧化氮暴露的增加与下呼吸道症状的年风险显著增加50%相关（OR = 1.5, 95% CI =[1.2,1.8]）。仿真结果表明，在与这些数据相似的条件下，估计器是无偏的，覆盖概率接近标称值。使用本文所述的方法，可以利用所有可用数据，对二氧化氮暴露对下呼吸道症状的影响进行34%的精确估计，并根据使用二氧化氮替代品而不是直接测量二氧化氮而导致的测量误差进行了调整。
In 1991, Neas et al. reported that indoor nitrogen dioxide (NO2) a byproduct of high-temperature combustion, was significantly associated with lower respiratory symptoms among a cohort of 1159 white children aged 7-11 years in six US cities studied from 1983 to 1988. For each 15 p.p.b. increment of NO2, the multivariate adjusted odds ratio (OR) was 1.4 (95% confidence interval (CI) = [1.1,1.7]). Although indoor NO2 concentration in the ambient air was assessed only in a subset of the children, the prevalence of lower respiratory symptoms and surrogate exposure variables were available in all of the children at the time of the indoor monitoring program. This paper evaluates the effect of indoor NO2 exposure on the annual risk of lower respiratory symptoms by applying a regression calibration method to the 2891 children in the overall study with complete covariate and outcome data, 1137 of whom had NO2 directly measured and 1754 of whom only surrogate exposure data were available. An estimate of the indoor annual NO2 exposure effect (p.p.b.) is obtained, which is adjusted for measurement error induced by the use of surrogate NO2 sources among the 1754. These sources include the presence of a gas stove with or without a pilot light, the presence of a kerosene space heater, the presence of a wood stove, and the usage of a stove for heating, and residential characteristics, including fan usage for kitchen ventilation and the total number of rooms in the home. After adjusting for age, gender, city, parental history of respiratory diseases, and smoking inside the children's home (packs/day), a 15-p.p.b. increment in NO2 exposure was found to be associated with a significant 50% increased annual risk of lower respiratory symptoms (OR = 1.5, 95% CI = [1.2,1.8]). Simulation results indicated that, under conditions similar to those observed in these data, the estimator is unbiased and has a coverage probability close to the nominal value. Using the methodology illustrated in this paper, it became possible to utilize all data available and obtain a 34% more precise estimate of the NO2 exposure effect on lower respiratory symptoms, which was adjusted for measurement error due to using NO2 surrogates instead of directly measured NO2.