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      Environmental Exposure Mixtures: Questions and Methods to Address Them

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      Current Epidemiology Reports
      Springer Science and Business Media LLC

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d1025374e117">Purpose of this review</h5> <p id="P1">This review provides a summary of statistical approaches that researchers can use to study environmental exposure mixtures. Two primary considerations are the form of the research question and the statistical tools best suited to address that question. Because the choice of statistical tools is not rigid, we make recommendations about when each tool may be most useful. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d1025374e122">Recent Findings</h5> <p id="P2">When dimensionality is relatively low, some statistical tools yield easily interpretable estimates of effect (e.g., risk ratio, odds ratio) or intervention impacts. When dimensionality increases, it is often necessary to compromise this interpretablity in favor of identifying interesting statistical signals from noise; this requires applying statistical tools that are oriented more heavily towards dimension reduction via shrinkage and/or variable selection. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d1025374e127">Summary</h5> <p id="P3">The study of complex exposure mixtures has prompted development of novel statistical methods. We suggest that further validation work would aid practicing researchers in choosing among existing and emerging statistical tools for studying exposure mixtures. </p> </div>

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          Most cited references31

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          The Bayesian Lasso

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            Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures.

            Because humans are invariably exposed to complex chemical mixtures, estimating the health effects of multi-pollutant exposures is of critical concern in environmental epidemiology, and to regulatory agencies such as the U.S. Environmental Protection Agency. However, most health effects studies focus on single agents or consider simple two-way interaction models, in part because we lack the statistical methodology to more realistically capture the complexity of mixed exposures. We introduce Bayesian kernel machine regression (BKMR) as a new approach to study mixtures, in which the health outcome is regressed on a flexible function of the mixture (e.g. air pollution or toxic waste) components that is specified using a kernel function. In high-dimensional settings, a novel hierarchical variable selection approach is incorporated to identify important mixture components and account for the correlated structure of the mixture. Simulation studies demonstrate the success of BKMR in estimating the exposure-response function and in identifying the individual components of the mixture responsible for health effects. We demonstrate the features of the method through epidemiology and toxicology applications.
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              Is Open Access

              Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review and Meta-Analysis

              Background: Particulate matter (PM) in outdoor air pollution was recently designated a Group I carcinogen by the International Agency for Research on Cancer (IARC). This determination was based on the evidence regarding the relationship of PM2.5 and PM10 to lung cancer risk; however, the IARC evaluation did not include a quantitative summary of the evidence. Objective: Our goal was to provide a systematic review and quantitative summary of the evidence regarding the relationship between PM and lung cancer. Methods: We conducted meta-analyses of studies examining the relationship of exposure to PM2.5 and PM10 with lung cancer incidence and mortality. In total, 18 studies met our inclusion criteria and provided the information necessary to estimate the change in lung cancer risk per 10-μg/m3 increase in exposure to PM. We used random-effects analyses to allow between-study variability to contribute to meta-estimates. Results: The meta-relative risk for lung cancer associated with PM2.5 was 1.09 (95% CI: 1.04, 1.14). The meta-relative risk of lung cancer associated with PM10 was similar, but less precise: 1.08 (95% CI: 1.00, 1.17). Estimates were robust to restriction to studies that considered potential confounders, as well as subanalyses by exposure assessment method. Analyses by smoking status showed that lung cancer risk associated with PM2.5 was greatest for former smokers [1.44 (95% CI: 1.04, 1.22)], followed by never-smokers [1.18 (95% CI: 1.00, 1.39)], and then current smokers [1.06 (95% CI: 0.97, 1.15)]. In addition, meta-estimates for adenocarcinoma associated with PM2.5 and PM10 were 1.40 (95% CI: 1.07, 1.83) and 1.29 (95% CI: 1.02, 1.63), respectively. Conclusion: The results of these analyses, and the decision of the IARC Working Group to classify PM and outdoor air pollution as carcinogenic (Group 1), further justify efforts to reduce exposures to air pollutants that can arise from many sources. Citation: Hamra GB, Guha N, Cohen A, Laden F, Raaschou-Nielsen O, Samet JM, Vineis P, Forastiere F, Saldiva P, Yorifuji T, Loomis D. 2014. Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis. Environ Health Perspect 122:906–911; http://dx.doi.org/10.1289/ehp.1408092
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                Author and article information

                Journal
                Current Epidemiology Reports
                Curr Epidemiol Rep
                Springer Science and Business Media LLC
                2196-2995
                June 2018
                April 5 2018
                June 2018
                : 5
                : 2
                : 160-165
                Article
                10.1007/s40471-018-0145-0
                6329601
                30643709
                c8da2914-e17b-466f-bd35-d27880ec60f1
                © 2018

                http://www.springer.com/tdm

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