Bias due to misclassification of personal exposures in epidemiologic studies of indoor and outdoor air pollution

Abstract In this paper, we examine the nature and magnitude of bias resulting in the estimation of relative health risks ( RR ) and risk differences ( ΔR ) due to misclassifications of exposures and disease. Bias correction expressions depending on the misclassification parameters, sensitivity and specificity, as well as the observed risk indicators, RR or ΔR , are provided. Examples based on predictions of exposures of adults and children to both indoor and outdoor respirable particles suggest the potential for significant bias toward the null, if exposure or disease misclassifications are not properly acounted for in the epidemiologic studies of air pollution health effects.