PT - JOURNAL ARTICLE AU - Heinrich, Joachim AU - Thiering, Elisabeth AU - Rzehak, Peter AU - Krämer, Ursula AU - Hochadel, Matthias AU - Rauchfuss, Knut M AU - Gehring, Ulrike AU - Wichmann, H-Erich TI - Long-term exposure to NO<sub>2</sub> and PM<sub>10</sub> and all-cause and cause-specific mortality in a prospective cohort of women AID - 10.1136/oemed-2012-100876 DP - 2013 Mar 01 TA - Occupational and Environmental Medicine PG - 179--186 VI - 70 IP - 3 4099 - http://oem.bmj.com/content/70/3/179.short 4100 - http://oem.bmj.com/content/70/3/179.full SO - Occup Environ Med2013 Mar 01; 70 AB - 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.