title: Mortality among population with exposure to industrial air pollution containing nickel and other toxic metals.
abstract: OBJECTIVE
  To assess disease mortality among people with exposure to metal-rich particulate air pollution.
  
  
  METHODS
  We conducted a cohort study on mortality from 1981 to 2005 among 33,573 people living near a nickel/copper smelter in Harjavalta, Finland. Nickel concentration in soil humus was selected as an indicator for long-term exposure. Relative risks--adjusted for age, socioeconomic status, and calendar period--were calculated for three exposure zones.
  
  
  RESULTS
  The relative risks for diseases of the circulatory system by increasing exposure were 0.93 (95% confidence interval = 0.79 to 1.09), 1.20 (1.04 to 1.39), and 1.18 (1.00 to 1.39) among men and 1.01 (0.88 to 1.17), 1.20 (1.04 to 1.38), and 1.14 (0.97 to 1.33) among women. Exclusion of smelter workers from the cohort did not materially change the results.
  
  
  CONCLUSIONS
  Long-term environmental exposure to metal-rich air pollution was associated with increased mortality from circulatory diseases.
authors.affiliation: Department of Environmental Health, National Institute for Health and Welfare, University of Eastern Finland, Kuopio, Finland. kari.pasanen@thl.fi
authors.forename: Kari
authors.initials: K
authors.lastname: Pasanen
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.forename: Anu W
authors.initials: AW
authors.lastname: Turunen
authors.forename: Toni
authors.initials: T
authors.lastname: Patama
authors.forename: Ilkka
authors.initials: I
authors.lastname: Jussila
authors.forename: Sari
authors.initials: S
authors.lastname: Makkonen
authors.forename: Raimo O
authors.initials: RO
authors.lastname: Salonen
authors.forename: Pia K
authors.initials: PK
authors.lastname: Verkasalo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000633:toxicity; D000544:Alzheimer Disease / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D003300:Copper / Q000633:toxicity; D003920:Diabetes Mellitus / Q000401:mortality*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009532:Nickel / Q000633:toxicity*; D052638:Particulate Matter / Q000633:toxicity*; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012142:Respiratory Tract Neoplasms / Q000401:mortality*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D003300:Copper; D009532:Nickel