Is model-estimated PM2.5 exposure equivalent to station-observed in mortality risk assessment? A literature review and meta-analysis

Model-estimated air pollution exposure assessments have been extensively employed in the evaluation of health risks associated with air pollution. However, few studies synthetically evaluate the reliability of model-estimated PM2.5 products in health risk assessment by comparing them with ground-based monitoring station air quality data. In response to this gap, we undertook a meticulously structured systematic review and meta-analysis. Our objective was to aggregate existing comparative studies to ascertain the disparity in mortality effect estimates derived from model-estimated ambient PM2.5 exposure versus those based on monitoring station-observed PM2.5 exposure. We conducted searches across multiple databases, namely PubMed, Scopus, and Web of Science, using predefined keywords. Ultimately, ten studies were included in the review. Of these, seven investigated long-term annual exposure, while the remaining three studies focused on short-term daily PM2.5 exposure. Despite variances in the estimated Exposure-Response (E-R) associations, most studies revealed positive associations between ambient PM2.5 exposure and all-cause and cardiovascular mortality, irrespective of the exposure being estimated through models or observed at monitoring stations. Our meta-analysis revealed that all-cause mortality risk associated with model-estimated PM2.5 exposure was in line with that derived from station-observed sources. The pooled Relative Risk (RR) was 1.083 (95% CI: 1.047, 1.119) for model-estimated exposure, and 1.089 (95% CI: 1.054, 1.125) for station-observed sources (p = 0.795). In conclusion, most model-estimated air pollution products have demonstrated consistency in estimating mortality risk compared to data from monitoring stations. However, only a limited number of studies have undertaken such comparative analyses, underscoring the necessity for more comprehensive investigations to validate the reliability of these model-estimated exposure in mortality risk assessment.