@article{3030745,
    title = "Long-term exposure to air pollution and liver cancer incidence in six
European cohorts",
    author = "So, Rina and Chen, Jie and Mehta, Amar J. and Liu, Shuo and Strak, and Maciej and Wolf, Kathrin and Hvidtfeldt, Ulla A. and Rodopoulou, Sophia and and Stafoggia, Massimo and Klompmaker, Jochem O. and Samoli, Evangelia and and Raaschou-Nielsen, Ole and Atkinson, Richard and Bauwelinck, Mariska and and Bellander, Tom and Boutron-Ruault, Marie-Christine and Brandt, and Jorgen and Brunekreef, Bert and Cesaroni, Giulia and Concin, Hans and and Forastiere, Francesco and van Gils, Carla H. and Gulliver, John and and Hertel, Ole and Hoffmann, Barbara and de Hoogh, Kees and Janssen, Nicole and and Lim, Youn-Hee and Westendorp, Rudi and Jorgensen, Jeanette T. and and Katsouyanni, Klea and Ketzel, Matthias and Lager, Anton and Lang, Alois and and Ljungman, Petter L. and Magnusson, Patrik K. E. and Nagel, Gabriele and and Simonsen, Mette K. and Pershagen, Goran and Peter, Raphael S. and and Peters, Annette and Renzi, Matteo and Rizzuto, Debora and Sigsgaard, and Torben and Vienneau, Danielle and Weinmayr, Gudrun and Severi, Gianluca and and Fecht, Daniela and Tjonneland, Anne and Leander, Karin and Hoek, and Gerard and Andersen, Zorana J.",
    journal = "International Journal  of Cancer",
    year = "2021",
    volume = "149",
    number = "11",
    pages = "1887-1897",
    publisher = "Wiley",
    issn = "0020-7136",
    doi = "10.1002/ijc.33743",
    keywords = "air pollution; cohort study; liver cancer incidence; particulate matter",
    abstract = "Particulate matter air pollution and diesel engine exhaust have been
classified as carcinogenic for lung cancer, yet few studies have
explored associations with liver cancer. We used six European adult
cohorts which were recruited between 1985 and 2005, pooled within the
“Effects of low-level air pollution: A study in Europe” (ELAPSE)
project, and followed for the incidence of liver cancer until 2011 to
2015. The annual average exposure to nitrogen dioxide (NO2), particulate
matter with diameter <2.5 mu m (PM2.5), black carbon (BC), warm-season
ozone (O-3), and eight elemental components of PM2.5 (copper, iron,
zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated
by European-wide hybrid land-use regression models at participants’
residential addresses. We analyzed the association between air pollution
and liver cancer incidence by Cox proportional hazards models adjusting
for potential confounders. Of 330 064 cancer-free adults at baseline,
512 developed liver cancer during a mean follow-up of 18.1 years. We
observed positive linear associations between NO2 (hazard ratio, 95%
confidence interval: 1.17, 1.02-1.35 per 10 mu g/m(3)), PM2.5 (1.12,
0.92-1.36 per 5 mu g/m(3)), and BC (1.15, 1.00-1.33 per 0.5 10(-5)/m)
and liver cancer incidence. Associations with NO2 and BC persisted in
two-pollutant models with PM2.5. Most components of PM2.5 were
associated with the risk of liver cancer, with the strongest
associations for sulfur and vanadium, which were robust to adjustment
for PM2.5 or NO2. Our study suggests that ambient air pollution may
increase the risk of liver cancer, even at concentrations below current
EU standards."
}