Long-term exposure to NO2 and PM10 and all-cause and cause-specific mortality in a prospective cohort of women
- Joachim Heinrich1,
- Elisabeth Thiering1,
- Peter Rzehak1,2,
- Ursula Krämer3,
- Matthias Hochadel1,4,
- Knut M Rauchfuss5,
- Ulrike Gehring1,6,
- H-Erich Wichmann1,2
- 1Helmholtz Zentrum München—German Research Center for Environment and Health, Institute of Epidemiology I, Neuherberg, Germany
- 2Ludwig-Maximilians-University of Munich, Institute of Medical Informatics, Biometrics and Epidemiology, Chair of Epidemiology, Munich, Germany
- 3IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
- 4Institut für Herzinfarktforschung at the University of Heidelberg, Ludwigshafen, Heidelberg, Germany
- 5Department of Environmental Health, Toxicology, Epidemiology, North Rhine-Westphalia State Environment Agency (LANUV-NRW), Essen, Germany
- 6Utrecht University, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
- Correspondence to Dr Joachim Heinrich, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology I, Ingolstädter Landstraße 1, Neuherberg D-85764, Germany;
- Received 10 May 2012
- Revised 19 October 2012
- Accepted 12 November 2012
- Published Online First 8 December 2012
We assessed whether long-term exposure to air pollution is associated with all-cause and cause-specific mortality during a period of declining particulate matter concentrations.
Approximately 4800 women aged 55 years from North Rhine-Westphalia, Germany, were followed for up to 18 years. Exposure to air pollution was assessed in two ways: (1) using the distance between the residential address and the nearest major road, as calculated from Geographic Information System data and (2) calculating 1-year average particulate matter concentrations below 10 µm (PM10) and nitrogen dioxide (NO2) levels using data from the nearest air-monitoring station data to the subjects’ residences. Ninety-two per cent of all subjects lived in the same community during the entire follow-up period. Associations between mortality and exposure were assessed using Cox's proportional hazards models, including confounder adjustment.
Sixteen per cent of women passed away during the follow-up period. An increase of 7 μg/m3 PM10 (IQR) was associated with an increased HR for all-cause (HR 1.15, 95% CI (1.04 to 1.27)), cardiopulmonary (HR 1.39, 95% CI (1.17 to 1.64)), and lung cancer mortality (HR 1.84, 95% CI (1.23 to 2.74)). An increase of 16 μg/m3 (IQR) NO2 exposure was associated with all-cause (HR 1.18, 95% CI (1.07 to 1.30)) and cardiopulmonary mortality (HR 1.55, 95% CI (1.30 to 1.84)). The association between cardiopulmonary mortality and PM10 was reduced for the extended follow-up period, during which PM10 concentrations (but not NO2 concentrations) were lower. Living close to a major road was associated with an increased relative risk for all-cause, cardiopulmonary and respiratory mortality. These associations were temporally stable.
Long-term exposure to ambient PM10 and NO2 was associated with increased mortality rates.
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