TY - JOUR
T1 - Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project
T2 - Pooled analysis
AU - Strak, MacIej
AU - Weinmayr, Gudrun
AU - Rodopoulou, Sophia
AU - Chen, Jie
AU - De Hoogh, Kees
AU - Andersen, Zorana J.
AU - Atkinson, Richard
AU - Bauwelinck, Mariska
AU - Bekkevold, Terese
AU - Bellander, Tom
AU - Boutron-Ruault, Marie Christine
AU - Brandt, Jørgen
AU - Cesaroni, Giulia
AU - Concin, Hans
AU - Fecht, Daniela
AU - Forastiere, Francesco
AU - Gulliver, John
AU - Hertel, Ole
AU - Hoffmann, Barbara
AU - Hvidtfeldt, Ulla Arthur
AU - Janssen, Nicole A.H.
AU - Jöckel, Karl Heinz
AU - Jørgensen, Jeanette T.
AU - Ketzel, Matthias
AU - Klompmaker, Jochem O.
AU - Lager, Anton
AU - Leander, Karin
AU - Liu, Shuo
AU - Ljungman, Petter
AU - Magnusson, Patrik K.E.
AU - Mehta, Amar J.
AU - Nagel, Gabriele
AU - Oftedal, Bente
AU - Pershagen, Göran
AU - Peters, Annette
AU - Raaschou-Nielsen, Ole
AU - Renzi, Matteo
AU - Rizzuto, Debora
AU - Van Der Schouw, Yvonne T.
AU - Schramm, Sara
AU - Severi, Gianluca
AU - Sigsgaard, Torben
AU - Sørensen, Mette
AU - Stafoggia, Massimo
AU - Tjønneland, Anne
AU - Monique Verschuren, W.
AU - Vienneau, Danielle
AU - Wolf, Kathrin
AU - Katsouyanni, Klea
AU - Brunekreef, Bert
AU - Hoek, Gerard
AU - Samoli, Evangelia
N1 - Funding Information:
Funding: This work was supported by Health Effects Institute (HEI) research agreement (grant No 4954-RFA14-3/16-5-3). Research described in this article was conducted under contract to the HEI, an organisation jointly funded by the US Environmental Protection Agency (EPA) (assistance award No R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: support from the Health Effects Institute for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work. Ethical approval: All included cohort studies were approved by the medical ethics committees in their respective countries. Data sharing: No additional data available. The corresponding author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
Publisher Copyright:
©
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. Design Pooled analysis of eight cohorts. Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries. Participants 325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM 2.5), nitrogen dioxide, ozone, and black carbon. Main outcome measures Deaths due to natural causes and cause specific mortality. Results Of 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM 2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 μg/m 3 in PM 2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 μg/m 3 increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM 2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 μg/m 3 an increase of 5 μg/m 3 in PM 2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths. Conclusions Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
AB - Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. Design Pooled analysis of eight cohorts. Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries. Participants 325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM 2.5), nitrogen dioxide, ozone, and black carbon. Main outcome measures Deaths due to natural causes and cause specific mortality. Results Of 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM 2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 μg/m 3 in PM 2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 μg/m 3 increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM 2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 μg/m 3 an increase of 5 μg/m 3 in PM 2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths. Conclusions Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
UR - http://www.scopus.com/inward/record.url?scp=85114298591&partnerID=8YFLogxK
U2 - 10.1136/bmj.n1904
DO - 10.1136/bmj.n1904
M3 - Article
AN - SCOPUS:85114298591
SN - 0959-8146
VL - 374
JO - The BMJ
JF - The BMJ
M1 - n1904
ER -
