title: Long-term exposure to ambient air pollution and cardiopulmonary mortality in women.
abstract: BACKGROUND
  Living close to major roads or highways has been suggested to almost double the risk of dying from cardiopulmonary causes. We assessed whether long-term exposure to air pollution originating from motorized traffic and industrial sources is associated with total and cause-specific mortality in a cohort of women living in North Rhine-Westphalia, Germany.
  
  
  METHODS
  The study was a follow-up of a series of cross-sectional studies carried out during the 1980s and 1990s on the health of women (age 50-59 years). Approximately 4800 women were followed up for vital status and migration. Exposure to air pollution was defined by distance to major roads calculated from Geographic Information System data and by 1- and 5-year average nitrogen dioxide (NO2) and particle (PM10) concentrations calculated from air monitoring station data. We analyzed associations between exposure and mortality using Cox's proportional hazards models adjusting for confounders. Relative risks (RRs) refer to an interquartile range increase in exposure (16 microg/m for NO2; 7 microg/m for PM10).
  
  
  RESULTS
  During the follow-up period, 8% of the women died, 3% from cardiopulmonary causes. Cardiopulmonary mortality was associated with living within a 50-meter radius of a major road (adjusted RR = 1.70; 95% confidence interval = 1.02-2.81), with NO2 (1.57; 1.23-2.00 for 1-year average), and with PM10 (1.34; 1.06-1.71 for 1-year average). Exposure to NO2 was also associated with all-cause mortality (1.17; 1.02-1.34). No association was seen with noncardiopulmonary nonlung cancer mortality.
  
  
  CONCLUSIONS
  Living close to major roads and chronic exposure to NO2 and PM10 may be associated with an increased mortality due to cardiopulmonary causes.
authors.affiliation: GSF-National Research Center for Environment and Health, Institute of Epidemiology, Ingolstaedter Landstrasse 1, D-85764 Neuherberg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.forename: Veit
authors.initials: V
authors.lastname: Grote
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Dorothea
authors.initials: D
authors.lastname: Sugiri
authors.forename: Martin
authors.initials: M
authors.lastname: Kraft
authors.forename: Knut
authors.initials: K
authors.lastname: Rauchfuss
authors.forename: Hans Georg
authors.initials: HG
authors.lastname: Eberwein
authors.forename: H-Erich
authors.initials: HE
authors.lastname: Wichmann
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects*; D002423:Cause of Death; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019049:Developed Countries / Q000706:statistics & numerical data; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D007221:Industry; D008875:Middle Aged; D009026:Mortality; D009585:Nitrogen Dioxide / Q000009:adverse effects*; D052638:Particulate Matter / Q000009:adverse effects*; D016016:Proportional Hazards Models; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012306:Risk; D012737:Sex Factors; D001335:Vehicle Emissions
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions; D009585:Nitrogen Dioxide