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Abstract:
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Multiple outcomes can strengthen epidemiological studies on environmental exposure effects by using information from correlated sources to reduce estimation error and increase power of detection. Besides taking into account the correlation among multiple outcomes, some models in the literature have also adopted the idea of a scaled exposure effect to examine the overall impact of environmental exposure on outcomes that can be similarly affected. In this paper, we extend that idea and also incorporate the estimation and testing of non-linear exposure effects on multiple outcomes in a latent variable model. We apply our model to the study of lead exposure effect on children's behavioral development in a Mexican cohort, where the negative influence of lead on multiple psychometric scales exhibits a ceiling effect for high-level exposure.
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