To : Cc: Bcc: Subject: Fw: Coorespondence from Dr. Brooks - Re: Clarifications in 2008 J Occup Environ Med

article

From: "Brooks, Edward G" <brookse@uthscsa.edu> To: Molini Patel/RTP/USEPA/US@EPA Cc: "Petronella, Sharon A." <spetrone@utmb.edu> Date: 02/23/2010 02:52 PM Subject: FW: clarifications in 2008 J Occup Environ Med article

Dr. Patel

Thank you for your careful review of our manuscript . I've reviewed our raw data files carefully and have corroborated the erro rs you noted below . Please let me know if you notice any more inconsistencies. I will submit corrections to the journal.

Sincerely

Ed Brooks

Edward G. Brooks, MD UTHSCSA, Dept. of Pediatrics Division of Immunology and Infectious Disease, Rm. 528L 7703 Floyd Curl Drive San Antonio, Texas 78229-3900 brookse@uthscsa.edu tel: 210-567-5250 fax: 210-567-6305

________________________________ From: Patel.Molini@epamail.epa.gov [Patel.Molini@ep amail.epa.gov] Sent: Thursday, February 04, 2010 12:17 PM To: Brooks, Edward G. Subject: clarifications in 2008 J Occup Environ Medarticle

Dear Dr. Brooks,

There appear to be a few discrepancies between tabl es and description of results in your 2008 J Occup Environ Med article, " Moderate Increases in Ambient PM2.5 and Ozone Are Associated with Lung Fu nction Decreases in Beach Lifeguards." I did not find a published erratum, s o I'm hoping you can provide clarification.

Thaller, E. I., Petronella, S. A., Hochman, D., How ard, S., Chhikara, R. S. and Brooks, E. G. (2008). "Moderate increases in ambient PM2.5 and ozone are associated with lung function decreases in beach li feguards." J Occup Environ Med 50 (2): 202-11.

1. In Table 2, the point estimate and 95% CI for da ily maximum O3 and FVC among asthmatics are -0.07 (-0.5 to -0.4). The poi nt estimate is outside the range of 95% CI, and in the results (pg 206, Effect s of PM2.5 and O3), you state "...there was a significant drop in the FEV1/ FVC ratio with increases in average and maximum O3..., but no change in FVC (P = 0.69 and P = 0.36)..." Should the upper limit of the 95% CI be +0.4?

[Edward G. Brooks] Yes, you are correct ; the table should read -0.07 (-0.5 to 0.4).2. In the results section on Effects of Gender, As thma, and Smoking on pg

206, you state, "The FEV1/FVC ratio was decreased i n both asthmatics (P = 0.05) and non-asthmatics (P=0.02) with increasing a verage O3 exposures, but increases in maximum O3 was associated with a decre ase in FEV1/FVC only in non-asthmatics (P =0.01)" In Table 3, the 95% CI f or daily average O3 is -1.1 to -0.08 for asthmatics is -0.4 to -0.02 for nonast hmatics. Have the p-values been switched or could you have switched asthmatic and non-asthmatic data in the table? Additionally, for daily maximum O3, the point estimate and 95% CI for asthmatics are -0.4 (-0.7 to -0.08) which indic ate that daily maximum O3 was associated with a significant decrease in FEV1/ FVC in asthmatics. The point estimate and 95% CI for non-asthmatics are -0 .1 (-0.2 to 0). This association is only borderline significant, and the p-value cannot be 0.01.

[Edward G. Brooks] You are correct in that the FEV 1/FVC change for asthmatics for average ozone P value is .022, and for non-asth matics P=.03, the data is otherwise correct. Also the FEV 1/FVC in asthmatics with max ozone was significant ( p =.01) and for non-asthmatics was non-significant ( p =.06). This was correct in the table but not in the text. In addition to the above changes, I also found an e rror in the Rsquared value Table 3, average ozone, all data, should be .005, not .071.

[Edward G. Brooks] I appreciate your feedback on th ese inconsistencies.

Sincerely,

Molini M. Patel, PhD, MPH Epidemiologist U.S. Environmental Protection Agency National Center for Environmental Assessment Mail drop: B243-01 Research Triangle Park, NC 27711 Telephone: (919) 541-1492 Email: patel.molini@epa.gov