12.07.2015 Views

Review of the Air Quality Criteria Document for Particulate Matter

Review of the Air Quality Criteria Document for Particulate Matter

Review of the Air Quality Criteria Document for Particulate Matter

SHOW MORE
SHOW LESS
  • No tags were found...

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

<strong>for</strong>mation <strong>of</strong> secondary particles, which are <strong>the</strong> actual toxic agents. NO 2 concentration (or itssources) might be considered as a “surrogate” <strong>for</strong> <strong>the</strong> proximal causal agent, PM.The third transparency provides diagrams <strong>for</strong> confounding and modification. As alreadymentioned, NO 2 is an unlikely confounder, given <strong>the</strong> lack <strong>of</strong> evidence <strong>of</strong> <strong>the</strong> increase in mortalitywith rising NO 2 concentrations. However, assuming that it were a risk factor <strong>for</strong> increasedmortality, <strong>the</strong> diagram represents <strong>the</strong> relationships <strong>for</strong> confounding. If NO 2 level modified <strong>the</strong>effect <strong>of</strong> PM, <strong>the</strong>n a set <strong>of</strong> relative risks describing <strong>the</strong> association <strong>of</strong> PM with mortality wouldbe derived, corresponding to <strong>the</strong> strata <strong>of</strong> NO 2 .There are a number <strong>of</strong> o<strong>the</strong>r epidemiological concepts to be considered in <strong>the</strong> <strong>Criteria</strong><strong>Document</strong>:· Confounding versus potential confounding: Throughout <strong>the</strong> document <strong>the</strong>re shouldbe careful attention to whe<strong>the</strong>r conditions <strong>for</strong> confounding are met. As noted,raising <strong>the</strong> possibility <strong>of</strong> confounding does not mean that confounding is actuallypresent.· Interaction: In places, <strong>the</strong> term “interaction” is used, generally in place <strong>of</strong> effectmodification. Interaction properly refers to <strong>the</strong> statistical terms used in a model to assesseffect modification.· The mixture problem: Admittedly, ambient air pollution is a complex mixture, <strong>of</strong>which PM is one component. None<strong>the</strong>less, <strong>the</strong> Clean <strong>Air</strong> Act has designated PM ando<strong>the</strong>r “criteria” pollutants <strong>for</strong> regulation. Study designs and data analysis are directed atattempting to characterize <strong>the</strong> effects <strong>of</strong> PM and <strong>the</strong>se o<strong>the</strong>r pollutants, and not that <strong>of</strong> <strong>the</strong>mixture itself. The criteria pollutants provide some indication <strong>of</strong> <strong>the</strong> characteristics <strong>of</strong><strong>the</strong>se mixtures and consideration <strong>of</strong> effect modification represents an indirect approach tounderstanding <strong>the</strong> toxicity <strong>of</strong> mixtures. The <strong>Criteria</strong> <strong>Document</strong> should acknowledge <strong>the</strong>mixture issue and <strong>the</strong> related requirements <strong>of</strong> <strong>the</strong> Clean <strong>Air</strong> Act specifically.· Measurement Error: This is a key issue that should be addressed in Chapters 5 and 6.Throughout <strong>the</strong> document, <strong>the</strong> concept <strong>of</strong> measurement error is considered but <strong>the</strong>underlining <strong>for</strong>mulations are variable and not necessarily accurate. The document shouldbe made uni<strong>for</strong>m <strong>for</strong> this key issue. The consequences <strong>of</strong> measurement error arecomplex and its potential consequences should be listed, at least in a general fashion.· Heterogeneity : The <strong>Criteria</strong> <strong>Document</strong> considers <strong>the</strong> heterogeneity <strong>of</strong> risk estimatesacross <strong>the</strong> United States. This heterogeneity cannot be completely explained byavailable, but crude, indicators. Heterogeneity does need to be explained, but itspresence is not a barrier to interpreting <strong>the</strong> findings on particulate matter. Additionally,summary estimates at a national level can be made in <strong>the</strong> face <strong>of</strong> heterogeneity as <strong>the</strong>yintrinsically weight <strong>the</strong> U.S. population’s exposure by <strong>the</strong> underlying distributionalmodifying factors.Interpretation <strong>of</strong> epidemiological data: Chapter 6 <strong>of</strong>fers a relatively literal interpretation <strong>of</strong> <strong>the</strong>epidemiological evidence, absent a clear biological framework. In interpreting epidemiologicaldata, <strong>the</strong> need <strong>for</strong> a foundation in biological understanding is evident. However, Chapter 6 aspresently authored, makes little connection to <strong>the</strong> substantial literature that is reviewed in o<strong>the</strong>rchapters. These connections should be made in Chapter 6 and <strong>the</strong>n rein<strong>for</strong>ced in Chapter 9.A - 77

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!