Abstract：
OBJECTIVE: Headache is one of the most prevalent and disabling health conditions globally. We prospectively explored the urban exposome in relation to weekly occurrence of headache episodes using data from the Dutch population-based Occupational and Environmental Health Cohort Study (AMIGO).
METHODS: Participants (N = 7,339) completed baseline and follow-up questionnaires in 2011 and 2015, reporting headache frequency. Information on the urban exposome covered 80 exposures across 10 domains, such as air pollution, electromagnetic fields, and lifestyle and socio-demographic characteristics. We first identified all relevant exposures using the Boruta algorithm and then, for each exposure separately, we estimated the average treatment effect (ATE) and related standard error (SE) by training causal forests adjusted for age, depression diagnosis, painkiller use, general health indicator, sleep disturbance index and weekly occurrence of headache episodes at baseline.
RESULTS: Occurrence of weekly headache was 12.5 % at baseline and 11.1 % at follow-up. Boruta selected five air pollutants (NO2, NOX, PM10, silicon in PM10, iron in PM2.5) and one urban temperature measure (heat island effect) as factors contributing to the occurrence of weekly headache episodes at follow-up. The estimated causal effect of each exposure on weekly headache indicated positive associations. NO2 showed the largest effect (ATE = 0.007 per interquartile range (IQR) increase; SE = 0.004), followed by PM10 (ATE = 0.006 per IQR increase; SE = 0.004), heat island effect (ATE = 0.006 per one-degree Celsius increase; SE = 0.007), NOx (ATE = 0.004 per IQR increase; SE = 0.004), iron in PM2.5 (ATE = 0.003 per IQR increase; SE = 0.004), and silicon in PM10 (ATE = 0.003 per IQR increase; SE = 0.004).
CONCLUSIONS: Our results suggested that exposure to air pollution and heat island effects contributed to the reporting of weekly headache episodes in the study population.
METHODS: Participants (N = 7,339) completed baseline and follow-up questionnaires in 2011 and 2015, reporting headache frequency. Information on the urban exposome covered 80 exposures across 10 domains, such as air pollution, electromagnetic fields, and lifestyle and socio-demographic characteristics. We first identified all relevant exposures using the Boruta algorithm and then, for each exposure separately, we estimated the average treatment effect (ATE) and related standard error (SE) by training causal forests adjusted for age, depression diagnosis, painkiller use, general health indicator, sleep disturbance index and weekly occurrence of headache episodes at baseline.
RESULTS: Occurrence of weekly headache was 12.5 % at baseline and 11.1 % at follow-up. Boruta selected five air pollutants (NO2, NOX, PM10, silicon in PM10, iron in PM2.5) and one urban temperature measure (heat island effect) as factors contributing to the occurrence of weekly headache episodes at follow-up. The estimated causal effect of each exposure on weekly headache indicated positive associations. NO2 showed the largest effect (ATE = 0.007 per interquartile range (IQR) increase; SE = 0.004), followed by PM10 (ATE = 0.006 per IQR increase; SE = 0.004), heat island effect (ATE = 0.006 per one-degree Celsius increase; SE = 0.007), NOx (ATE = 0.004 per IQR increase; SE = 0.004), iron in PM2.5 (ATE = 0.003 per IQR increase; SE = 0.004), and silicon in PM10 (ATE = 0.003 per IQR increase; SE = 0.004).
CONCLUSIONS: Our results suggested that exposure to air pollution and heat island effects contributed to the reporting of weekly headache episodes in the study population.
摘要：
目的：头痛是全球最普遍和致残的健康状况之一。我们使用荷兰基于人群的职业和环境健康队列研究（AMIGO）的数据，前瞻性地探讨了与每周头痛发作有关的城市风险。
方法：参与者（N=7,339）在2011年和2015年完成了基线和随访问卷，报告了头痛频率。关于城市曝光的信息涵盖了10个领域的80个曝光，比如空气污染，电磁场,生活方式和社会人口特征。我们首先使用Boruta算法识别所有相关的曝光，然后，对于每个单独的曝光，我们通过训练按年龄调整的因果森林来估计平均治疗效果(ATE)和相关标准误差(SE)，抑郁症诊断,止痛药的使用，一般健康指标，睡眠障碍指数和基线时每周头痛发作的发生。
结果：基线时每周头痛发生率为12.5%，随访时发生率为11.1%。Boruta选择了五种空气污染物(NO2，NOX，PM10，PM10中的硅，PM2.5中的铁）和一项城市温度测量（热岛效应）是导致随访时每周头痛发作的因素。每次暴露对每周头痛的估计因果效应表明正相关。NO2显示出最大的影响（ATE=每四分位数间距（IQR）增加0.007；SE=0.004），其次是PM10(每IQR增加ATE=0.006；SE=0.004)，热岛效应（ATE=每增加一摄氏度0.006；SE=0.007），NOx（每IQR增加ATE=0.004；SE=0.004），PM2.5中的铁(ATE=0.003每IQR增加；SE=0.004)，和PM10中的硅(每IQR增加一次ATE=0.003；SE=0.004)。
结论：我们的结果表明，暴露于空气污染和热岛效应有助于报告研究人群中每周的头痛发作。
方法：参与者（N=7,339）在2011年和2015年完成了基线和随访问卷，报告了头痛频率。关于城市曝光的信息涵盖了10个领域的80个曝光，比如空气污染，电磁场,生活方式和社会人口特征。我们首先使用Boruta算法识别所有相关的曝光，然后，对于每个单独的曝光，我们通过训练按年龄调整的因果森林来估计平均治疗效果(ATE)和相关标准误差(SE)，抑郁症诊断,止痛药的使用，一般健康指标，睡眠障碍指数和基线时每周头痛发作的发生。
结果：基线时每周头痛发生率为12.5%，随访时发生率为11.1%。Boruta选择了五种空气污染物(NO2，NOX，PM10，PM10中的硅，PM2.5中的铁）和一项城市温度测量（热岛效应）是导致随访时每周头痛发作的因素。每次暴露对每周头痛的估计因果效应表明正相关。NO2显示出最大的影响（ATE=每四分位数间距（IQR）增加0.007；SE=0.004），其次是PM10(每IQR增加ATE=0.006；SE=0.004)，热岛效应（ATE=每增加一摄氏度0.006；SE=0.007），NOx（每IQR增加ATE=0.004；SE=0.004），PM2.5中的铁(ATE=0.003每IQR增加；SE=0.004)，和PM10中的硅(每IQR增加一次ATE=0.003；SE=0.004)。
结论：我们的结果表明，暴露于空气污染和热岛效应有助于报告研究人群中每周的头痛发作。
