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American Journal of Epidemiology Vol. 155, No. 1 : 11-15
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health

ORIGINAL CONTRIBUTIONS

Invited Commentary: Air Pollution and Health—What Can We Learn from a Hierarchical Approach?

Francesca Dominici

From the Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room E4138, Baltimore, MD 21205 (e-mail: fdominic@jhsph.edu).

Abbreviations: NMMAPS, National Morbidity, Mortality, and Air Pollution Study; PM10, particulate matter <= 10 µm in diameter


   INTRODUCTION
 
The potential for air pollution to cause excess deaths at high concentrations was established in the mid-20th century by a series of air pollution "disasters" in the United States and Europe (1GoGo–3Go) that caused striking increases in mortality. By the early 1990s, time-series studies, each conducted at a single location (4GoGoGo–7Go), showed that air pollution levels, even at much lower concentrations, were associated with increased rates of mortality and morbidity in cities in the United States, Europe, and other developed regions. At present, although these relative rates are small (an increase in mortality or morbidity of a few percentage points over a realistic exposure range), the burden of disease attributable to air pollution may be substantial, considering the very large populations exposed to air pollution and the large numbers of persons to whom the relative rates of mortality or morbidity apply.

In the past, critics of . . . [Full Text of this Article]


   HIERARCHICAL MODELS
 
Stage I: site
Stage II: the Taiwan region

   HETEROGENEITY AND EFFECT MODIFICATION
 

   PUBLICATION BIAS
 

   CONCLUSIONS
 

   NOTES
 

   REFERENCES
 

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