Τίτλος:
Variability in the association between long-term exposure to ambient air pollution and mortality by exposure assessment method and covariate adjustment: A census-based country-wide cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. Methods: We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). Results: We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 μg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 μg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. Conclusion: Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method. © 2021
Συγγραφείς:
Bauwelinck, M.
Chen, J.
de Hoogh, K.
Katsouyanni, K.
Rodopoulou, S.
Samoli, E.
Andersen, Z.J.
Atkinson, R.
Casas, L.
Deboosere, P.
Demoury, C.
Janssen, N.
Klompmaker, J.O.
Lefebvre, W.
Mehta, A.J.
Nawrot, T.S.
Oftedal, B.
Renzi, M.
Stafoggia, M.
Strak, M.
Vandenheede, H.
Vanpoucke, C.
Van Nieuwenhuyse, A.
Vienneau, D.
Brunekreef, B.
Hoek, G.
Περιοδικό:
The Science of the Total Environment
Λέξεις-κλειδιά:
Air pollution; Biological organs; Cardiology; Hazards; Land use; Nitrogen oxides; Pulmonary diseases; Random processes; Risk assessment, Ambient air pollution; Cause-specific mortality; Covariates; Environmental hazards; Exposure assessment; Hazard ratio; Health effects; Lung cancer mortality; Population-based; Survival analysis, Surveys, atmospheric pollution; black carbon; cancer; cardiovascular disease; environmental hazard; health impact; health risk; mortality; nitrogen dioxide; pollution exposure; respiratory disease, Belgium; Europe, adult; adverse event; air pollutant; air pollution; cohort analysis; environmental exposure; human; particulate matter; population research, Adult; Air Pollutants; Air Pollution; Censuses; Cohort Studies; Environmental Exposure; Humans; Particulate Matter
DOI:
10.1016/j.scitotenv.2021.150091
