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Recent epidemiologic and toxicologic evidence indicates significant modification of pollution effects on health by chronic psychosocial stress [ 5– 12].
This type of time-series study has limited capacity to take account of spatial variation in individual exposures or to investigate the possible modification of pollution effects by individual risk factors such as age, smoking history, and previous disease, although analysis using case-crossover methods (Carracedo-Martinez et al. 2010) may reduce some of these difficulties.
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Modification of air pollution effects by SNPs was, however, clearest for CO, although the other pollutants in general followed a similar pattern.
Our clearest results regarding genetic modification of air pollution effects concern the IL6 gene.
This is a particular concern when examining effect modification of air pollution health risks obtained without spatially resolved exposure estimates.
We did not observe any statistically significant modification of air pollution effects by LINE-1 or Alu methylation (results not shown).
We used this method recently to examine the effect modification of air pollution by individual smoking status and physical activity (Wong et al. 2007a, 2007b).
Some U.S. studies indicate effect modification of air pollution by socioeconomic status (SES) with much stronger effects among the less educated (Pope et al. 2002).
Finally, using interaction terms we examined effect modification of air pollution by race and ethnicity (Hispanic, non-Hispanic white, non-Hispanic black) to investigate the hypothesis that certain racial or ethnic groups might have differing susceptibility to ambient air pollution.
However, the possible modification of air pollution effects associated with socioeconomic status, assessed at the neighborhood level, has not been well studied, and findings are still controversial (O'Neill et al. 2003).
The effect modification of air pollution by socioeconomic status measured at the individual level has been demonstrated in several epidemiologic studies (Filleul et al. 2004; HEI 2000; Krewski et al. 2005).
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