Case-crossover design in air pollution epidemiology

Jouni Jaakkola

    Research output: Contribution to journalArticle

    77 Citations (Scopus)


    The case-crossover design was developed to study the effects of transient, short-term exposures on the risk of acute events, such as myocardial infarction, in the early 1990s. This paper illustrates how the principles of case-crossover design are related to the principles of crossover and case-control designs and stipulates the possibilities of case-crossover design in air pollution epidemiology. In the case-crossover design, the study population consists of subjects who have experienced an episode of the health outcome of interest. Similar to a crossover study, each subject serves as his or her own control. As in a matched case-control study, the inference is based on a comparison of exposure distribution rather than the risk of disease. The case-crossover study is most suitable for studying relations with the following characteristics: 1) the individual exposure varies within short time intervals; 2) the disease has abrupt onset and short latency for detection; and 3) the induction period is short. Case-crossover design allows use of routinely monitored air pollution information and at the same time makes it possible to study individuals rather than days as the unit of observation. Case-crossover design is amenable for studying the effects of varying short-term air pollution exposure on health outcomes with an abrupt onset, such as myocardial infarction or asthma attack.
    Original languageEnglish
    Pages (from-to)81s-85s
    JournalEuropean Respiratory Journal. Supplement
    Publication statusPublished - 1 May 2003


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