A scalable two-stage Bayesian approach accounting for exposure measurement error in environmental epidemiology

Accounting for exposure measurement errors has been recognized as a crucial problem in environmental epidemiology for over two decades. Bayesian hierarchical models offer a coherent probabilistic framework for evaluating associations between environmental exposures and health effects, which take into account exposure measurement errors introduced by uncertainty in the estimated exposure as well as spatial misalignment between the exposure and health outcome data. While two-stage Bayesian analyses are often regarded as a good alternative to fully Bayesian analyses when joint estimation is not feasible, there has been minimal research on how to properly propagate uncertainty from the first-stage exposure model to the second-stage health model, especially in the case of a large number of participant locations along with spatially correlated exposures. We propose a scalable two-stage Bayesian approach, called a sparse multivariate normal (sparse MVN) prior approach, based on the Vecchia approximation for assessing associations between exposure and health outcomes in environmental epidemiology. We compare its performance with existing approaches through simulation. Our sparse MVN prior approach shows comparable performance with the fully Bayesian approach, which is a gold standard but is impossible to implement in some cases. We investigate the association between source-specific exposures and pollutant (nitrogen dioxide [NO2])-specific exposures and birth weight of full-term infants born in 2012 in Harris County, Texas, using several approaches, including the newly developed method.