Impact of long-term temporal trends in fine particulate matter (PM2.5) on associations of annual PM2.5 exposure and mortality: An analysis of over 20 million Medicare beneficiaries.

ABSTRACT: Decreasing ambient fine particulate matter (PM2.5) concentrations over time together with increasing life expectancy raise concerns about temporal confounding of associations between PM2.5 and mortality. To address this issue, we examined PM2.5-associated mortality risk ratios (MRRs) estimated for approximately 20,000,000 US Medicare beneficiaries, who lived within six miles of an Environmental Protection Agency air quality monitoring site, between December 2000 and December 2012. We assessed temporal confounding by examining whether PM2.5-associated MRRs vary by study period length. We then evaluated three approaches to control for temporal confounding: (1) assessing exposures using the residual of PM2.5 regressed on time; (2) adding a penalized spline term for time to the health model; a

SUBMITTER: Eum KD 

PROVIDER: S-EPMC8493859 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature