Empirical Bayes and Adjusted Estimates Approach to Estimating the Relation of Mortality to Exposure of Pm(10)

In the framework of the APHEIS program (Air Pollution and Health: A European Information System), a health impact assessment of air pollution in 26 European cities was performed for particles of an aerodynamic diameter less than or equal to 10 mm (PM)(10). For short-term effects, it was based on overall estimates from the APHEA-2 project (Air Pollution and Health: A European Approach). These city-specific risk assessments require city-specific concentration-response functions, raising the question of which concentration-response is most appropriate. Estimates from city-specific models are more specific, but have greater uncertainty than those provided from multicity analyses. We compared several estimates derived from the city-specific analyses in cities that were part of the APHEA-2 project, as well as in a city that was not included in APHEA-2 but was part of the APHEIS project. These estimates were: the estimates from a local regression model, the adjusted estimates based on two significant effect modifiers identified through meta-regression models, and the city-specific empirical Bayes (shrunken) estimates and their underlying distribution. The shrunken and adjusted estimates were used to improve the estimation of city-specific concentration-response function. From these different estimates, attributable numbers of deaths per year were calculated. The advantages and limits of the different approaches are discussed through real data and in a simulation study