Our results may be biased due to residual confounding. Urinary creatinine adjustment has been recommended for urinary biomarkers to correct for dilutions of pollutant concentrations in spot urine samples [76]. The main purpose of the present study is to introduce a novel ERS approach as a proof of concept illustration rather than to identify potential environmental factors related to health outcomes and estimate the associations as done in previous EWAS. Variance may be somewhat underestimated and the observed findings may not be generalizable to the US population.
