Περίληψη:
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 (PM2.5), 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 PM2.5, nitrogen dioxide, and
black carbon was associated with significantly increased risk of almost
all outcomes. An increase of 5 mu g/m(3) in PM2.5 was associated with
13% (95% confidence interval 10.6% to 15.5%) increase in natural
deaths; the corresponding figure for a 10 mu g/m(3) increase in nitrogen
dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen
dioxide, and black carbon remained significant at low concentrations.
For participants with exposures below the US standard of 12 mu g/m(3) an
increase of 5 mu g/m(3) in PM2.5 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.
Συγγραφείς:
Strak, Maciej
Weinmayr, Gudrun
Rodopoulou, Sophia
Chen, Jie
and de Hoogh, Kees
Andersen, Zorana J.
Atkinson, Richard and
Bauwelinck, Mariska
Bekkevold, Terese
Bellander, Tom and
Boutron-Ruault, Marie-Christine
Brandt, Jorgen
Cesaroni, Giulia
and Concin, Hans
Fecht, Daniela
Forastiere, Francesco and
Gulliver, John
Hertel, Ole
Hoffmann, Barbara
Hvidtfeldt,
Ulla Arthur
Janssen, Nicole A. H.
Jockel, Karl-Heinz and
Jorgensen, Jeanette
Ketzel, Matthias
Klompmaker, Jochem and
Lager, Anton
Leander, Karin
Liu, Shuo
Ljungman, Petter and
Magnusson, Patrik K. E.
Mehta, Amar J.
Nagel, Gabriele and
Oftedal, Bente
Pershagen, Goran
Peters, Annette and
Raaschou-Nielsen, Ole
Renzi, Matteo
Rizzuto, Debora
van der
Schouw, Yvonne T.
Schramm, Sara
Severi, Gianluca
Sigsgaard,
Torben
Sorensen, Mette
Stafoggia, Massimo
Tjonneland, Anne
and Verschuren, W. M. Monique
Vienneau, Danielle
Wolf, Kathrin
and Katsouyanni, Klea
Brunekreef, Bert
Hoek, Gerard
Samoli,
Evangelia
