JAMA Forum: A Breath of Bad Air: Trump Environmental Agenda May Lead to 80 000 Extra Deaths per Decade

JAMA Forum | May 10, 2018 By David Cutler, PhD, and Francesca Dominici, PhD President Donald Trump and Environmental Protection Agency (EPA) Administrator Scott Pruitt have pledged to reexamine landmark environmental policies and to repeal regulations. In their view, excessive regulations are harming US industry, and thus reducing regulation will be good for business. As Donald Trump has said, seemingly without irony, “We are going to get rid of the…

Clever use of public data could sidestep new rule

Science | May 4, 2018 Critics of the Environmental Protection Agency’s (EPA’s) move last week to limit the agency’s use of nonpublic data say it is a thinly veiled effort to prevent regulators from drawing on public health studies that have proved pivotal to justifying tougher air pollution limits. Recently, however, one research team has demonstrated what could be a way around the policy. They used publicly available data to…

Association of Short-term Exposure to Air Pollution With Mortality in Older Adults

JAMA | December 26, 2017 What is the association between short-term exposure to air pollution below current air quality standards and all-cause mortality? In a case-crossover study of more than 22 million deaths, each 10-μg/m3 daily increase in fine particulate matter and 10–parts-per-billion daily increase in warm-season ozone exposures were associated with a statistically significant increase of 1.42 and 0.66 deaths per 1 million persons at risk per day, respectively.…

Impact of National Ambient Air Quality Standards nonattainment designations on particulate pollution and health

Epidemiology | October 31, 2017 Despite dramatic air quality improvement in the United States over the past decades, recent years have brought renewed scrutiny and uncertainty surrounding the effectiveness of specific regulatory programs for continuing to improve air quality and public health outcomes. Read abstract here

High-dimensional confounding adjustment using continuous spike and slab priors

In observational studies, estimation of a causal effect of a treatment on an outcome relies on proper adjustment for confounding. If the number of the potential confounders ( p ) is larger than the number of observations ( n ), then direct control for all potential confounders is infeasible. Existing approaches for dimension reduction and penalization are generally aimed at predicting the outcome, and are less suited for estimation of…

Propensity scores with misclassified treatment assignment: a likelihood-based adjustment

Oxford University Press | April 17, 2017 Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact…

Best Practices for Gauging Evidence of Causality in Air Pollution Epidemiology

American Journal of Epidemiology | September 6, 2017 The contentious political climate surrounding air pollution regulations has brought some researchers and policy makers to argue that evidence of causality is necessary for more stringent regulations. Recently, an increasing number of air pollution studies purport the use of “causal analysis,” generating the impression that studies not explicitly labeled as such are merely “associational” and therefore less rigorous. Using three prominent air…

Air Pollution and Mortality in the Medicare Population

New England Journal of Medicine | June 29, 2017 Studies have shown that long-term exposure to air pollution increases mortality. However, evidence is limited for air-pollution levels below the most recent National Ambient Air Quality Standards. Previous studies involved predominantly urban populations and did not have the statistical power to estimate the health effects in underrepresented groups. Read more here

Air Pollution Still Kills

Editorial, New England Journal of Medicine | June 29, 2017 In late October 1948, a dense smog descended over the town of Donora, Pennsylvania. The town was home to a zinc plant and a steel mill, both run by the United States Steel Corporation. Susan Gnora, a 62-year-old resident of Donora, started to gasp and cough as the smog descended. She died the next day. Dr. William Rongaus, a physician…

Drought linked with human health risks in US analysis, Berman et al.

In a retrospective study of health claims for 618 U.S. counties over 14 years, published in The Lancet, researchers found that severe drought conditions increased the risk of mortality among adults 65 or over. They also found that individuals in places where droughts were rare, such as counties in Minnesota, showed a larger risk of mortality and cardiovascular disease compared with counties where drought is more common. Read more here