Confounding and causation in the epidemiology of lead

Wilson, Ian Harold and Wilson, Simon Barton (2016) Confounding and causation in the epidemiology of lead. International Journal of Environmental Health Research, 1-16. doi:10.1080/09603123.2016.1161179

Author Wilson, Ian Harold
Wilson, Simon Barton
Title Confounding and causation in the epidemiology of lead
Journal name International Journal of Environmental Health Research   Check publisher's open access policy
ISSN 1369-1619
Publication date 2016-03-20
Year available 2016
Sub-type Article (original research)
DOI 10.1080/09603123.2016.1161179
Open Access Status Not Open Access
Start page 1
End page 16
Total pages 16
Place of publication Abingdon, Oxfordshire, United Kingdom
Publisher Taylor & Francis
Collection year 2017
Language eng
Abstract The National Health and Medical Research Council recently reported that there were not enough high-quality studies to conclude that associations between health effects and blood lead levels <10 μg/dL were caused by lead. It identified uncontrolled confounding, measurement error and other potential causal factors as common weaknesses. This paper supports those findings with evidence of uncontrolled confounding by parental education, intelligence or household management from several papers. It suggests that inappropriate statistical tests and aggregation of data representing different exposure routes partly explain why confounding has been overlooked. Inadequate correction of confounding has contributed to incorrect conclusions regarding causality at low levels of lead. Linear or log-linear regression models have tended to mask any threshold. While the effects of higher levels of lead exposure are not disputed, overestimation of health effects at low lead exposures has significant implications for policy-makers endeavouring to protect public health through cost-effective regulations.
Keyword Bias
Lead epidemiology
Statistical analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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