title: Association between long-term exposure to air pollution and specific causes of mortality in Scotland.
abstract: OBJECTIVE
  This study investigated the association between long-term exposure to black smoke (BS) air pollution and mortality in two related Scottish cohorts with 25 years of follow-up.
  
  
  METHODS
  Risk factors were collected during 1970-1976 for 15331 and 6680 participants in the Renfrew/Paisley and Collaborative cohorts respectively. Exposure to BS during 1970-1979 was estimated by inverse-distance weighted averages of observed concentrations at monitoring sites and by two alternative spatial modelling approaches which included local air quality predictors (LAQP).
  
  
  RESULTS
  Consistent BS-mortality associations (per 10 μg m(-3) increment in 10-year average BS) were observed in the Renfrew/Paisley cohort using LAQP-based exposure models (all-cause mortality HR 1.10 (95% CI 1.04 to 1.17); cardiovascular HR 1.11 (1.01 to 1.22); ischaemic heart disease HR 1.13 (1.02 to 1.25); respiratory HR 1.26 (1.02 to 1.28)). The associations were largely unaffected by additional adjustment for area-level deprivation category. A less consistent and generally implausible pattern of cause-specific BS-mortality associations was found for inverse-distance averaging of BS concentrations at nearby monitoring sites. BS-mortality associations in the Collaborative cohort were weaker and not statistically significant.
  
  
  CONCLUSIONS
  The association between mortality and long-term exposure to BS observed in the Renfrew/Paisley cohort is consistent with hypotheses of how air pollution may affect human health. The dissimilarity in pollution-mortality associations for different exposure models highlights the critical importance of reliable estimation of exposures on intraurban spatial scales to avoid potential misclassification bias.
authors.affiliation: Department of Civil Engineering, University of Strathclyde, John Anderson Building, 107 Rottenrow, Glasgow G4 0NG, UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Yap
authors.forename: Iain J
authors.initials: IJ
authors.lastname: Beverland
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Heal
authors.forename: Geoffrey R
authors.initials: GR
authors.lastname: Cohen
authors.forename: Chris
authors.initials: C
authors.lastname: Robertson
authors.forename: Deborah E J
authors.initials: DE
authors.lastname: Henderson
authors.forename: Neil S
authors.initials: NS
authors.lastname: Ferguson
authors.forename: Carole L
authors.initials: CL
authors.lastname: Hart
authors.forename: George
authors.initials: G
authors.lastname: Morris
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Agius
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012606:Scotland / Q000453:epidemiology; D012906:Smoke / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D012906:Smoke