Dataset Information

Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis.

ABSTRACT:

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 (PM_2.5), 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 PM_2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 µg/m³ in PM_2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 µg/m³ increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM_2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 µg/m³ an increase of 5 µg/m³ in PM_2.5 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.

SUBMITTER: Strak M

PROVIDER: S-EPMC8409282 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Publications

Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis.

Strak Maciej M Weinmayr Gudrun G Rodopoulou Sophia S Chen Jie J de Hoogh Kees K Andersen Zorana J ZJ Atkinson Richard R Bauwelinck Mariska M Bekkevold Terese T Bellander Tom T Boutron-Ruault Marie-Christine MC Brandt Jørgen J Cesaroni Giulia G Concin Hans H Fecht Daniela D Forastiere Francesco F Gulliver John J Hertel Ole O Hoffmann Barbara B Hvidtfeldt Ulla Arthur UA Janssen Nicole A H NAH Jöckel Karl-Heinz KH Jørgensen Jeanette T JT Ketzel Matthias M Klompmaker Jochem O JO Lager Anton A Leander Karin K Liu Shuo S Ljungman Petter P Magnusson Patrik K E PKE Mehta Amar J AJ Nagel Gabriele G Oftedal Bente B Pershagen Göran G Peters Annette A Raaschou-Nielsen Ole O Renzi Matteo M Rizzuto Debora D van der Schouw Yvonne T YT Schramm Sara S Severi Gianluca G Sigsgaard Torben T Sørensen Mette M Stafoggia Massimo M Tjønneland Anne A Verschuren W M Monique WMM Vienneau Danielle D Wolf Kathrin K Katsouyanni Klea K Brunekreef Bert B Hoek Gerard G Samoli Evangelia E

BMJ (Clinical research ed.) 20210901

<h4>Objective</h4>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.<h4>Design</h4>Pooled analysis of eight cohorts.<h4>Setting</h4>Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries.<h4>Participants</h4>325 367 adults from the general population recruited mostly in the 1990s or 2000s with detaile ...[more]

PMID: 34470785

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Project description:BackgroundInconsistent associations between long-term exposure to particles with an aerodynamic diameter ≤2.5 μm [fine particulate matter (PM2.5)] components and mortality have been reported, partly related to challenges in exposure assessment.ObjectivesWe investigated the associations between long-term exposure to PM2.5 elemental components and mortality in a large pooled European cohort; to compare health effects of PM2.5 components estimated with two exposure modeling approaches, namely, supervised linear regression (SLR) and random forest (RF) algorithms.MethodsWe pooled data from eight European cohorts with 323,782 participants, average age 49 y at baseline (1985-2005). Residential exposure to 2010 annual average concentration of eight PM2.5 components [copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V), and zinc (Zn)] was estimated with Europe-wide SLR and RF models at a 100×100 m scale. We applied Cox proportional hazards models to investigate the associations between components and natural and cause-specific mortality. In addition, two-pollutant analyses were conducted by adjusting each component for PM2.5 mass and nitrogen dioxide (NO2) separately.ResultsWe observed 46,640 natural-cause deaths with 6,317,235 person-years and an average follow-up of 19.5 y. All SLR-modeled components were statistically significantly associated with natural-cause mortality in single-pollutant models with hazard ratios (HRs) from 1.05 to 1.27. Similar HRs were observed for RF-modeled Cu, Fe, K, S, V, and Zn with wider confidence intervals (CIs). HRs for SLR-modeled Ni, S, Si, V, and Zn remained above unity and (almost) significant after adjustment for both PM2.5 and NO2. HRs only remained (almost) significant for RF-modeled K and V in two-pollutant models. The HRs for V were 1.03 (95% CI: 1.02, 1.05) and 1.06 (95% CI: 1.02, 1.10) for SLR- and RF-modeled exposures, respectively, per 2 ng/m3, adjusting for PM2.5 mass. Associations with cause-specific mortality were less consistent in two-pollutant models.ConclusionLong-term exposure to V in PM2.5 was most consistently associated with increased mortality. Associations for the other components were weaker for exposure modeled with RF than SLR in two-pollutant models. https://doi.org/10.1289/EHP8368.

Project description:Short-term exposure to air pollution has adverse effects among patients with asthma, but whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear.We aimed to investigate the association between air pollution and adult onset asthma.Asthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual average concentrations at home addresses for nitrogen oxides assessed for 23,704 participants (including 1,257 incident cases) and particulate matter (PM) assessed for 17,909 participants through ESCAPE land-use regression models and traffic exposure indicators. Meta-analyses of cohort-specific logistic regression on asthma incidence were performed. Models were adjusted for age, sex, overweight, education, and smoking and included city/area within each cohort as a random effect.In this longitudinal analysis, asthma incidence was positively, but not significantly, associated with all exposure metrics, except for PMcoarse. Positive associations of borderline significance were observed for nitrogen dioxide [adjusted odds ratio (OR) = 1.10; 95% CI: 0.99, 1.21 per 10 ?g/m3; p = 0.10] and nitrogen oxides (adjusted OR = 1.04; 95% CI: 0.99, 1.08 per 20 ?g/m3; p = 0.08). Nonsignificant positive associations were estimated for PM10 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 10 ?g/m3), PM2.5 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 5 ?g/m3), PM2.5absorbance (adjusted OR = 1.06; 95% CI: 0.95, 1.19 per 10-5/m), traffic load (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 4 million vehicles × meters/day on major roads in a 100-m buffer), and traffic intensity (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 5,000 vehicles/day on the nearest road). A nonsignificant negative association was estimated for PMcoarse (adjusted OR = 0.98; 95% CI: 0.87, 1.14 per 5 ?g/m3).Results suggest a deleterious effect of ambient air pollution on asthma incidence in adults. Further research with improved personal-level exposure assessment (vs. residential exposure assessment only) and phenotypic characterization is needed.

Dataset Information

Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis.

Similar Datasets

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