Evaluating the Sensitivity of Mortality Attributable to Pollution to Modeling Choices: A Case Study for Colorado

We evaluated the sensitivity of estimated PM2.5 and NO2 health impacts to varying key input parameters and assumptions including: 1) the spatial scale at which impacts are estimated, 2) using either a single concentration-response function (CRF) or using racial/ethnic group specific CRFs from the same epidemiologic study, 3) assigning exposure to residents based on home, instead of home and work locations. This analysis was carried out for the state of Colorado. We found that the spatial scale of the analysis influences the magnitude of NO2, but not PM2.5, attributable deaths. Using county-level predictions instead of 1 km2 predictions of NO2 resulted in a lower estimate of mortality attributable to NO2 by ~ 50% for all of Colorado for each year between 2000-2020. Using an all-population CRF instead of racial/ethnic group specific CRFs results in a higher estimate of annual mortality attributable to PM2.5 by a factor 1.3 for the white population and a lower estimate of mortality attributable to PM2.5 by factors of 0.4 and 0.8 for Black and Hispanic residents, respectively. Using racial/ethnic group specific CRFs did not result in a different estimation of NO2 attributable mortality for white residents, but led to lower estimates of mortality by a factor of ~ 0.5 for Black residents, and by a factor of 2.9 for to Hispanic residents. Using NO2 based on home instead of home and workplace locations results in a smaller estimate of annual mortality attributable to NO2 for all of Colorado by ~0.980 each year and 0.997 for PM2.5.