title: Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study.
abstract: BACKGROUND
  Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association.
  
  
  METHODS
  We followed up 52 061 participants in a Danish cohort for mortality in the nationwide Register of Causes of Death, from enrollment in 1993-1997 through 2009, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO₂) since 1971 as indicator of traffic air pollution and used Cox regression models to estimate mortality rate ratios (MRRs) with adjustment for potential confounders.
  
  
  RESULTS
  Mean levels of NO₂ at the residence since 1971 were significantly associated with mortality from cardiovascular disease (MRR, 1.26; 95% confidence interval [CI], 1.06-1.51, per doubling of NO₂ concentration) and all causes (MRR, 1.13; 95% CI, 1.04-1.23, per doubling of NO₂ concentration) after adjustment for potential confounders. For participants who ate < 200 g of fruit and vegetables per day, the MRR was 1.45 (95% CI, 1.13-1.87) for mortality from cardiovascular disease and 1.25 (95% CI, 1.11-1.42) for mortality from all causes.
  
  
  CONCLUSIONS
  Traffic air pollution is associated with mortality from cardiovascular diseases and all causes, after adjustment for traffic noise. The association was strongest for people with a low fruit and vegetable intake.
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark. ole@cancer.dk
authors.forename: Ole
authors.initials: O
authors.lastname: Raaschou-Nielsen
authors.forename: Zorana Jovanovic
authors.initials: ZJ
authors.lastname: Andersen
authors.forename: Steen Solvang
authors.initials: SS
authors.lastname: Jensen
authors.forename: Matthias
authors.initials: M
authors.lastname: Ketzel
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
authors.forename: Johnni
authors.initials: J
authors.lastname: Hansen
authors.forename: Steffen
authors.initials: S
authors.lastname: Loft
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
mesh_terms: D000393:Air Pollutants / Q000633:toxicity; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000633:toxicity; D009622:Noise; D001335:Vehicle Emissions / Q000633:toxicity*
chemical_list: D000393:Air Pollutants; D001335:Vehicle Emissions; D009585:Nitrogen Dioxide