Measurement error correction methods for the effects of ambient air pollution on mortality and morbidity using the UK Biobank cohort: the MELONS study
Author(s)
Type
Journal Article
Abstract
Epidemiological cohort studies associating long-term exposure to ambient air pollution with health outcomes most often do not account for individually assigned exposure measurement error. Here, we implemented Cox proportional hazards models to explore the relationships between NO2, PM2.5 and ozone exposures with the incidence of natural-cause mortality and several morbidity outcomes in 61,797 London-dwelling respondents of the UK Biobank cohort. Data from an existing personal monitoring campaign was used as an external validation dataset to estimate measurement error structures between “true” personal exposure and several surrogate (measured and modelled) estimates of assigned exposure, allowing for the application of two health effect estimate correction methodologies: regression calibration (RCAL) and simulation extrapolation (SIMEX). Uncorrected hazard ratios (HRs) suggested an increase in the risk of natural-cause mortality for modelled NO2 estimates (HR: 1.028 [0.983, 1.074] per IQR increment of 14.54 μg/m3) and no statistically significant association was observed for PM2.5 surrogate exposure measures. Measurement error corrected HRs were generally larger in magnitude, although exhibited wider confidence intervals than uncorrected effect estimates. Chronic obstructive pulmonary disease (COPD) was associated with increased exposure to modelled NO2 (1.087 [1.022, 1.155]). Both RCAL and SIMEX correction resulted in increased HRs (1.254 [1.061, 1.482] and 1.192 [1.093, 1.301], respectively). SIMEX correction of modelled PM2.5 (IQR: 1.72 μg/m3) associations with COPD increased the HR (1.079 [1.001, 1.164]) in comparison to uncorrected (1.042 [0.988, 1.099]). These findings suggest that health effect estimates not corrected for exposure measurement error may lead to underestimation in the magnitude of effects.
Date Issued
2025-11-01
Date Acceptance
2025-06-24
Citation
Environmental Research, 2025, 284
ISSN
0013-9351
Publisher
Elsevier
Journal / Book Title
Environmental Research
Volume
284
Copyright Statement
© 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40582549
PII: S0013-9351(25)01488-4
Subjects
Air pollution
AREAS
Environmental Sciences
Environmental Sciences & Ecology
EUROPEAN COHORTS
Exposure measurement error
JOINT EXPOSURE
Life Sciences & Biomedicine
Long-term exposure
LONG-TERM EXPOSURE
MODEL
Morbidity
Mortality
NO2
Personal exposure
PM2.5
POLLUTANTS
Public, Environmental & Occupational Health
RISK
Science & Technology
STROKE
Publication Status
Published
Coverage Spatial
Netherlands
Article Number
122237
Date Publish Online
2025-06-28